ECHO 2013 / Echocardiography in Congenital and Structural Heart Disease Assessment of Device – Repaired Patients
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Pulmonary Valve
Replacement
Pulmonary Valve Replacement
24 Year old female
TOF/PA, s/p RV=PA conduit placement
Progressive, “free” PR, trivial PS
SOB on exertion
RVEDVi = 160 cc/m2 on MRI
Pulmonary Valve Replacement
Pulmonary Valve Replacement
Primarily a fluoroscopic procedure
•No echo needed during valve placement
•After valve implant, can’t do angiographic assessment of PR without having catheter across the valve
Pulmonary Valve Replacement
Edwards Sapien Valve
Pulmonary Valve Replacement
Pulmonary Valve Replacement
With Wire Across |
Wire Removed |
LAA CLOSURE
Left Atrial Appendage Closure
“Echo-dependent” procedure
Can’t see the appendage on fluoro
Can’t do angiograms with device in the LAA
Device positioning is critical
End results can best be assessed with echo
LA Appendage Closure
68 Year old female
2 prior embolic stroke
Major GI bleed on warfarin with good levels
Didn’t want to be on Factor Xa Inhibitor
Hypertension, DM II
CHADS2 Score = 4 (High risk for recurrence)
Currently on dual antiplatelet therapy (bruising)