TTE Protocol Intra Op TAVR

Sutter TTE Protocol Intra Op TAVR
SetupObtain height, weight, blood pressure on all patientsObtain ECG tracing; 3 beat loop; if HR >100 bpm increase #loops to 4, if greater than 120 bpm to 5 beatsDO NOT ACQUIRE IMAGES WITHOUT AN ADEQUATE ECG TRACING
View	Modality	Image	#beats
Intra op right after valve deployment
		PARASTERNAL LONG AXIS
1	2D	PLAX depth 5 cm (adequate to visualize pericardial/pleural effusion or	3
2	2D	PLAX depth 2 cm	3
3	Color	Aortic valve sweep	3
		AV SAX
4	2D	Aortic valve	3
5	Color	Aortic valve sweep
6	2D	Apical5ch	3
7	Color	Aortic valve	3
8	CW	Aortic valve	3
9	PW	*If AV mean gradient is > 12 mmHg or if LVOT/Mid cavity gradient is present	3
		Intra OP post assessment	*Label post
10	2D	PLAX depth 5 cm (adequate to visualize pericardial/pleural effusion or	3
11	2D	PLAX depth 2cm	3
12	Color	Aortic valve	3
13	Color Compare	Asc AO
14	Color	Mitral valve	3
15	2D	RV inflow- TV	3
16	Color	RV inflow- TV with color	3
17	CW	RV inflow- TR jet	3
18		PARASTERNAL SHORT AXIS
19	2D	AoV level, show TV, PV and left atrium	3
20	2D	Zoom AoV-show TAVR frame	3
21	Color	Zoom AoV sweep
22	2D	Tricuspid valve	3
23	Color	TV, TR jet	3
24	CW	TR jet	3
25	2	Mid LV (papillary muscle level) for RWMA	3
		Apical 4-Chamber View
26	2D	Apical 4-Chamber (all 4 chambers)	3
27	2D	Apical 4-Chamber (LV focused RWMA)	3x2
28	2D	Apical 4-Chamber (MV focused)	3
29	Color	MV inflow	3
30	2D	RV focused View	3
31	Color	RV focused (TV and TR jet)	3
32	CW	RV focused (TV and TR jet)	3
		Apical 5-Chamber View
33	2D	Apical 5-Chamber (all 5 chambers)	3
38	Color	Apical 5-Chamber (color box to display complete AR jet)	3
39	2D	Apical 5-Chamber (Zoom AoV)	3
40	2D	Apical 5-Chamber (Zoom AoV Color sweep)	3
41	PW	Apical 5-Chamber PW of LVOT, optimize baseline	3x2
42	CW	Apical 5-Chamber AV CW	3x2
		Apical 2-Chamber View
43	2D	Apical 2-Chamber (all chambers)	3x2
44	2D	Apical 2-Chamber focus on LV for RWMA
45	CW	Apical 2-Chamber (focus on MV, MR jet and MV inflow	3
		Apical 3-Chamber View
46	2D	Apical 3-Chamber (all 3 chambers)	3
47	Color	Apical 3-Chamber (color box to display complete AR jet)	3
48	2D	Apical 3-Chamber (Zoom AoV)
49	Color	Apical 3-Chamber (Zoom AoV) sweep	3
50	PW	Apical 3-Chamber PW of LVOT	3x2
51	CW	Apical 3-Chamber AV CW (optimize baseline to both AS and AR if needed	3x2
		Subcostal
52	2D	Subcostal, 4-chamber
53	2D	IVC
54	Color	IVC and hepatic vein
55	2D	Descending/abdominal aorta
56	PW	*Descending/abdominal aorta if moderate or greater AR
		PISA- please consider for moderate or greater regurgitation; aliasing velocity 30-38 cm/s