ECOCARDIOGRAFIA TRANSESOFÁGICA

Presentación del tema: "ECOCARDIOGRAFIA TRANSESOFÁGICA"— Transcripción de la presentación:

1 ECOCARDIOGRAFIA TRANSESOFÁGICA
ECOCARDIOGRAMA EN EL QUE LAS IMÁGENES SE OBTIENEN DE UN TRASDUCTOR SITUADO EN EL ESÓFAGO The development of tissue Doppler imaging has enabled the quantification of mitral annular ……..systolic and …..early …….and……late diastolic velocities

2 ETE VENTAJAS Comparado con el ETT Comparado con RM and TC
Proximidad (estructuras posteriores) Resolución de las imágenes Multi-plano Comparado con RM and TC se puede llevar a la cabecera del enfermo Resolución temporal Información funcional The development of tissue Doppler imaging has enabled the quantification of mitral annular ……..systolic and …..early …….and……late diastolic velocities

3 EQUIPO Sonda Transductor Ecocardiografo
The development of tissue Doppler imaging has enabled the quantification of mitral annular ……..systolic and …..early …….and……late diastolic velocities

4 SONDA Cuerpo Transductor Mango
The development of tissue Doppler imaging has enabled the quantification of mitral annular ……..systolic and …..early …….and……late diastolic velocities Mango

5 REALIZACIÓN DEL ETE Personal Preparación del paciente Sedación
Intubación Obtención de las imágenes The development of tissue Doppler imaging has enabled the quantification of mitral annular ……..systolic and …..early …….and……late diastolic velocities

6 PREPARACIÓN Historia del paciente Consentimiento informado
disfagia / anormalidades esofágicas Consentimiento informado riesgos, beneficios y alternativas Ayunas > 4hrs The development of tissue Doppler imaging has enabled the quantification of mitral annular ……..systolic and …..early …….and……late diastolic velocities

7 COMPLICACIONES Hipoxia Hipotension Hipertension Arritmia Hematemnesis
Laringospasmo Úlcera esofágica Muerte 0.6% 0.5% 0.2% 0.3% 0.1% <0.02% <0.01% We therefore designed this study to compare tissue Doppler velocities at different margins of the mitral valve annulus…….. And to determine the effect this has on estimates of LV filling pressure

8 PREPARACIÓN Acceso venoso Profilaxis antibiótica Sedacion
contraste salino Profilaxis antibiótica en general no se requiere. The development of tissue Doppler imaging has enabled the quantification of mitral annular ……..systolic and …..early …….and……late diastolic velocities

9 Anetesia tópica Lidocaina gel Lidocaina spray
The development of tissue Doppler imaging has enabled the quantification of mitral annular ……..systolic and …..early …….and……late diastolic velocities

10 SEDACIÓN Efectos ansiolíticos y amnésicos
Ambiente tranquilo y poca luz Fármacos Midazolam 1-10mg ev. The development of tissue Doppler imaging has enabled the quantification of mitral annular ……..systolic and …..early …….and……late diastolic velocities

11 MONITORIZACIÓN Ritmo cardiaco Presión arterial Saturación
Aspiración de secreciones The development of tissue Doppler imaging has enabled the quantification of mitral annular ……..systolic and …..early …….and……late diastolic velocities

12 INTUBACIÓN Posición del paciente Tragar decúbito lateral izquierdo
Flexión del cuello Tragar relajación del musculo cricofaríngeo

13 INTUBACIÓN

14 RECUPERACIÓN Vigilancia hasta que el efecto de la anestesia ha desaparecido Evitar comida y bebida hasta que el efecto de la anestesia tópica haya desaparecido No conducir en unas 12hrs

15 ESTUDIO CON CONTRASTE Se utiliza suero salino agitado, las burbujas de suero con ecodensas, se utilizan fundamentalmente para el diagnóstico de cortocircuitos derecha izquierda que no se visualizan rutinariamente (foramen oval permeable) The development of tissue Doppler imaging has enabled the quantification of mitral annular ……..systolic and …..early …….and……late diastolic velocities

16 VENTANAS basal cuatro camaras transgástrico apex nivel musculo papilar
profundo apex Mitral annular diastolic velocities provide useful information about LV diastolic function In particular the early diastolic velocity is inversely related to the time constant of LV pressure decay and thus acts as an index of LV relaxation The early diastolic velocity has also been shown to be relatively preload independent and is useful in differentiating pseudonormal from normal LV filling paterns

17 PLANOS Eje largo Eje corto Cuatro camaras The development of tissue Doppler imaging has enabled the quantification of mitral annular ……..systolic and …..early …….and……late diastolic velocities

18 PLANOS (2) Eje largo horizontal (4C) 0o Eje largo vertical (2C) 90o
Eje largo (3C) 120o Eje corto (TG) 0o Mitral annular diastolic velocities provide useful information about LV diastolic function In particular the early diastolic velocity is inversely related to the time constant of LV pressure decay and thus acts as an index of LV relaxation The early diastolic velocity has also been shown to be relatively preload independent and is useful in differentiating pseudonormal from normal LV filling paterns

19 CUATRO CAMARAS Mitral annular diastolic velocities provide useful information about LV diastolic function In particular the early diastolic velocity is inversely related to the time constant of LV pressure decay and thus acts as an index of LV relaxation The early diastolic velocity has also been shown to be relatively preload independent and is useful in differentiating pseudonormal from normal LV filling paterns

20 PLANO SUPERIOR 00 45-600 30-600 1200 45-600 Mitral annular diastolic velocities provide useful information about LV diastolic function In particular the early diastolic velocity is inversely related to the time constant of LV pressure decay and thus acts as an index of LV relaxation The early diastolic velocity has also been shown to be relatively preload independent and is useful in differentiating pseudonormal from normal LV filling paterns

21 PLANO TRASNGÁSTRICO 00 00 900 Mitral annular diastolic velocities provide useful information about LV diastolic function In particular the early diastolic velocity is inversely related to the time constant of LV pressure decay and thus acts as an index of LV relaxation The early diastolic velocity has also been shown to be relatively preload independent and is useful in differentiating pseudonormal from normal LV filling paterns 00

22 INDICACIONES Foco embolígeno Enfermedad Valvular Endocarditis
Pre-cardioversión Aorta enfermedades congénitas Masas Intracardiacas Embolismo pulmonar 42% 14% 11% 6% 5% 2% 1% We therefore designed this study to compare tissue Doppler velocities at different margins of the mitral valve annulus…….. And to determine the effect this has on estimates of LV filling pressure

23 Cuatro camaras, vegetacion en valvula mitral
We therefore designed this study to compare tissue Doppler velocities at different margins of the mitral valve annulus…….. And to determine the effect this has on estimates of LV filling pressure

24 Tracto de salida de ventrículo izquierdo, raíz aórtica
We therefore designed this study to compare tissue Doppler velocities at different margins of the mitral valve annulus…….. And to determine the effect this has on estimates of LV filling pressure

25 Válvula aórtica trivalva (normal)
We therefore designed this study to compare tissue Doppler velocities at different margins of the mitral valve annulus…….. And to determine the effect this has on estimates of LV filling pressure

26 Cuatro camaras, vegetacion en valvula mitral
We therefore designed this study to compare tissue Doppler velocities at different margins of the mitral valve annulus…….. And to determine the effect this has on estimates of LV filling pressure

27 Orejuela izquierda con trombo
We therefore designed this study to compare tissue Doppler velocities at different margins of the mitral valve annulus…….. And to determine the effect this has on estimates of LV filling pressure

28 Orejuela izquierda con trombo y ecocontraste espontáneo
We therefore designed this study to compare tissue Doppler velocities at different margins of the mitral valve annulus…….. And to determine the effect this has on estimates of LV filling pressure