TTE Protocol Pre imaging & S/P TAVR assessment

Sutter TTE Protocol Pre imaging & S/P TAVR assessment
Setup
Obtain height, weight, blood pressure on all patients
Obtain ECG tracing; 3 beat loop; if HR >100 bpm increase #loops to 4, if greater than 120 bpm to 5 beats
DO NOT ACQUIRE IMAGES WITHOUT AN ADEQUATE ECG TRACING
View	Modality	Image	#beats
1 Patient information page
		PARASTERNAL LONG AXIS
2	2D	PLAX depth 5 cm (adequate to visualize pericardial/pleural effusion or	3
3	2D	PLAX depth 2 cm (on axis for LV measurements	3
4	Color	Mitral and aortic valve	3
5	2D	AoV (Zoom; optimize for LVOT measurement; should include both Ao root sinuses)	3 x2
6	2D	Asc Ao measurement	3
7	Color	Asc Ao	3
8	3D	X-plane through AV leaflet tips	3
9	3D color	X-plane with color AV leaflet tips	3
10	2D	RV inflow- TV	3
11	Color	RV inflow- TV with color	3
12	CW	RV inflow- TR jet	3
13	2D	RV outflow PV	3
14	Color	RV outflow PV (focus on RVOT)	3
		PARASTERNAL SHORT AXIS
15	2D	AoV level, show TV, PV and left atrium	3
16	2D	Zoom AoV-show leaflet morphology	3
17	Color	Zoom AoV
18	2D	Tricuspid valve	3
19	Color	TV, TR jet	3
20	CW	TR jet	3
21	2D	Pulmonic valve	3
22	Color	PV, RVOT, PR jet	3
23	2D	Mitral valve	3
24	Color	Mitral valve color	3
25	2	Mid LV (papillary muscle level)	3
26	2D	Apical LV
		Apical 4-Chamber View
27	2D	Apical 4-Chamber (all 4 chambers)	3
28	2D	Apical 4-Chamber (LV focused- for biplane Simpson’s & RWMA)	3 x2
29	2D	Apical 4-Chamber Simpsons measurement
30	2D	Apical 4-Chamber (MV focused)	3
31	2D	Apical 4-Chamber (LA focused)	3
32	Color	MV inflow	3
33	2D	Apical 4 Chamber (LAA focused)	3
34	2D	RV focused View	3
35	Color	RV focused (TV and TR jet)	3
36	CW	RV focused (TV and TR jet)	3
		Apical 5-Chamber View
37	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)	5
41	PW	Apical 5-Chamber PW of LVOT, optimize baseline	3 x2
42	CW	Apical 5-Chamber AV CW	3 x2
		Apical 2-Chamber View
43	2D	Apical 2-Chamber	3 x2
44	2D	Apical 2-Chamber Simpsons measurement
45	2D	Apical 2-Chamber focus on (focus on LA)	3
46	Color	Apical 2-Chamber focus on MV	3
47	CW	Apical 2-Chamber (focus on MV, MR jet and MV inflow	3
		Apical 3-Chamber View
48	2D	Apical 3-Chamber (all 3 chambers)	3
49	Color	Apical 3-Chamber (color box to display complete AR jet)	3
50	2D	Apical 3-Chamber (Zoom AoV)
51	Color	Apical 3-Chamber (Zoom AoV) sweep	5
52	PW	Apical 3-Chamber PW of LVOT	3 x2
53	CW	Apical 3-Chamber AV CW (optimize baseline to both AS and AR if needed	3 x2
		Subcostal
54	2D	Subcostal, 4-chamber
55	Color	Subcostal, 4-chamber, focused MV and TV
56	2D	Interatrial septum (zoom)
57	Color	Interatrial septum (zoom) Color Nyquist <50 cm/s
58	2D	IVC
59	Color	IVC and hepatic vein
60	2D	Descending/abdominal aorta
61	PW	*Descending/abdominal aorta if moderate or greater AR
		PISA- please consider for moderate or greater regurgitation; aliasing velocity 30-38 cm/s
		3D & 3D color- feel free to acquire; single beat and multi-beat acquisitions
		Right parasternal border-for AS patients; please obtain if possible
		Anything more than mild valve disease interrogate