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Real-Time Embolization of a Massive Lead-Associated Thrombus Visualized by Transesophageal Echocardiography.

ABSTRACT: •Lead-associated thrombus is often seen in transvenous CIEDs.•Clinically apparent pulmonary embolism is uncommon.•Lead-associated thrombus can be massive and associated with morbidity and mortality.

SUBMITTER: Kehl DW

PROVIDER: S-EPMC6200713 | biostudies-literature | 2018 Oct

REPOSITORIES: biostudies-literature

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Real-Time Embolization of a Massive Lead-Associated Thrombus Visualized by Transesophageal Echocardiography.

Kehl Devin W DW Siegel Robert J RJ

CASE (Philadelphia, Pa.) 20180507 5

•Lead-associated thrombus is often seen in transvenous CIEDs.•Clinically apparent pulmonary embolism is uncommon.•Lead-associated thrombus can be massive and associated with morbidity and mortality. ...[more]

PMID: 30370388

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Diagnostic value of real-time four-dimensional transesophageal echocardiography on the implant-related thrombus.

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Quadricuspid aortic: valve revealed by real-time, 3-dimensional transesophageal echocardiography.

Project description: Not available

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Novel three-dimensional transesophageal echocardiography imaging of a highly mobile left atrial thrombus associated with stroke.

Project description: Not available

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Unknown left atrial appendage mass! real-time three-dimensional transesophageal echocardiography helps in identification.

Project description:Left Atrial Appendage (LAA) is the most contractile part of Left atrium. It is also the most frequent place for thrombus formation that may lead to disastrous consequences. Complete trasoesophageal echocardiography examination always includes assessing LAA but sometimes unusually placed pectinate muscle, which is a normal structure may give baffling shadow that can only be interpreted correctly by Real time 3D echocardiography.

| S-EPMC5791505 | biostudies-literature

Incidence and Predictors of Intracardiac Thrombus on Pre-electrophysiological Procedure Transesophageal Echocardiography.

Project description:BackgroundCerebral thromboembolism is a potentially devastating complication of atrial fibrillation (AF) and atrial flutter (AFl). The use of transesophageal echocardiogram (TEE) before electrophysiological procedures in anticoagulated patients is variable. Our objective was to determine the incidence and identify predictors of intracardiac left atrial appendage (LAA) thrombus on TEE in patients with AF/AFl before electrical cardioversion or ablation.MethodsWe reviewed TEEs of 401 patients undergoing an electrical cardioversion, AF, or AFl ablation from April 2013 to September 2015 at the McGill University Health Center. Clinical and echocardiographic variables were collected at the time of the TEE and follow-up visits. Multivariate logistic regression was used to determine predictors of LAA thrombus.ResultsOf 401 patients, 11.2% had LAA thrombus on TEE. The majority (87%) of patients were anticoagulated for at least 3 weeks before the TEE. The incidence of LAA thrombus was 21% (23/110) in patients taking warfarin vs 6.4% (15/236) in patients taking direct oral anticoagulants. Multivariate analysis identified prior stroke (odds ratio [OR], 2.7; 95% confidence interval [CI], 1.1-6.9) and heart failure (OR, 2.2; 95% CI, 1.0-4.7) as predictors of thrombus, whereas direct oral anticoagulant use (OR, 0.4; 95% CI, 0.2-0.8) was associated with reduced odds of thrombus.ConclusionsLAA thrombus was identified in a significant proportion of patients undergoing TEE before cardioversion or ablation of AF/AFl despite preprocedural anticoagulation. Patients at increased risk of LAA thrombus (heart failure and prior stroke) may benefit from TEE before cardioversion, AF, or AFl ablation.

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Patent foramen ovale diagnosed by real-time three-dimensional contrast transesophageal echocardiography: A case report.

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A Left Atrial Thrombus Mimic: Value of Ultrasound Enhancing Agents during Transesophageal Echocardiography.

Project description: Not available

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A Proposed Maneuver to Guide Transseptal Puncture Using Real-Time Three-Dimensional Transesophageal Echocardiography: Pilot Study.

Project description:Aim of Study. To assess the feasibility of a new proposed maneuver "RATLe-90" using real-time three-dimensional transesophageal echocardiography (RT-3DTEE) for anatomically oriented visualization of the interatrial septum (IAS) in guiding the transseptal puncture TSP. Methods. The study included 20 patients (mean age, 60.2 ± 6.7 years; 60% males) who underwent TSP for different indications. RT-3DTEE was used to guide TSP. The proposed maneuver RATLe-90 (Rotate-Anticlockwise-Tilt-Left-90) was applied in all cases to have the anatomically oriented en face view of the IAS from the right atrial (RA) aspect. Having this anatomically oriented view, we guided the TSP catheter towards the proper puncture site according to the planned procedure. Results. Using the RATLe-90 maneuver, the anatomically oriented en face view of the IAS from the RA was obtained in all patients. We were able to guide the puncture catheter to the proper puncture site on the IAS. The 3D images obtained were clearly understood by both echocardiographers and interventionists. The RATLe-90 maneuver acquisition time was 19.9 ± 1.6 seconds. The time-to-tent was 64.8 ± 16.3 seconds. Less TEE probe manipulations were needed while guiding the TSP. Conclusions. Application of RT3D-TEE during TSP using RATLe-90 maneuver is feasible with shorter fluoroscopy time and minimizing TEE probe manipulations.

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Retrograde Venous Bullet Embolization to the Hepatic Inferior Vena Cava Located with Intraoperative Transesophageal Echocardiography.

Project description:The authors present a case in which a GSW to the chest led to a retrograde venous bullet embolization. The fragment originated in the right atrium and embolized to the hepatic IVC, which was located with intraoperative TEE.

| S-EPMC6058393 | biostudies-literature

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