Mohd Farid

Mohd Farid

Saturday, September 29, 2012

The Sonographer Attachment Programme At USA Report : Mayo Clinic: Sonographer Experience =Ventricular Assisst Device=



Ventricular Assist Device : Role Of The Sonographer


-Look for most recent implant CXR or Chest CT
-Review image from previous echo
-Involve responsible MD sooner rather than later
-After patient is roomed, confirm the battery is with patient
-Find surgical note:device type
-Find surgical note:anatomic placement details (position of outflow cannula insertion)

Ventricular Assist Device : TTE In VAD Patients

>> Parasternal Window

- LVIDd,LVIDs
- RV size and function
- LV apical inflow cannula (2D and Color Flow)
- Outflow cannula (If it is in the Asc Ao, try Right Parasternal Window)
- LVOT and RVOT diameter
- RVOT TVI for Cardiac Output calculations
- Is the Aortic Opening?
- Assessment of AR, MR and TR

>> Apical/Para Apical Window

- Apical inflow cannula (2D and Color Flow)
- Assessment of MR,TR and AR
- RV size and function
- LVOT PW TVI (if aortic valve is opening)
- Pulse wave and color flow Doppler of inflow cannula
- Note pericardial effusion or constructions
- May need to measure diameters, assess color flow and aortic valve opening at various    flow setting

- If flow adjustments are desired, a VAD coordinator should be present to change flows or to disable device during echo study

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