TTE Protocol Intra Op TAVR: Difference between revisions
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!View !! Modality !! Image !! #beats | !View !! Modality !! Image !! #beats | ||
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| | |Intra op right after valve deployment || || || | ||
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| || || PARASTERNAL LONG AXIS || | | || || PARASTERNAL LONG AXIS || | ||
Revision as of 14:46, 11 October 2025
Setup
- Obtain height, weight, blood pressure on all patients
- Obtain ECG tracing
- 3 beat loop
- If HR > 100 bpm increase number of loops to 4 beats
- If HR > 120 bpm increase number of loops to 5 beats
- 3 beat loop
Warning: DO 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 |
