Echo-of-the-Day

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AMA Category 1 Credit for Physicians Only.
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Echo-of-the-Day Information

The Echo-of-the-Day is a presentation of 1 or more video loops to present an important topic in echocardiography. Please reveiw the image or video loops and then answer the questions below. After you have answered the questions you can view the explanation and obtain CME credit (if available).

You can change the size and the format of the image or video loops by using the links below the image or video loop.

= MP4 Video	= Ogg Video
= WebM Video	= GIF Image
Image/Video Sizes	= JPG Image
1X = 200x150 pixels 2X = 400x300 pixels	3X = 600x450 pixels 4X = 800x600 pixels

Loop Text Key
Preop	Preop TEE or TTE
Intraop	An Intraop TEE
IntraopPreOp	Intraop TEE or TTE before Operation
IntraopPostOp	Intraop TEE or TTE after Operation
IntraopEnd	Intraop TEE or TTE at End of Anesthesia
Post Op	Postop TEE or TTE

Echo of the Day Information Table

IntraopEnd is usually a TEE after the Operation and after some event occured to show a change in the TEE

Ascending Aorta

Case#: 37

AMA CME Units: 0.25 Units
Estimated Time: 15 minutes.

Presentation:
A patient scheduled for a CABG w/ECC w/EVH has the following loop:

Loop(s):

Case Discussion

The echocardiographic findings are a PAC in the right pulmonary artery, a linear artifact that is a mirror artifact from the PAC in the ascending aorta (although this wold have to be confirmed that it is not an aortic flap), and an irregular endocardial border of the ascending aorta . The irregular endocardium is atherosclerosis that is protruding and immobile. The protruding plaque is about 1 cm in length.

The classification of this atherosclerosis is a grade 4 lesion. A grade 4 lesion indicates that the risk of stroke is about 11%.

Because of the risk of stroke the ascending aorta should not be cannulated or cross clamped. Also, SVG should be placed by a punch technique rather than a partial cross clamp. An epiaortic scan should be performed to identify other areas of significant atherosclerosis. Depending upon the epiaortic scan, an ascending aortic replacement should be considered.

CME Section

Please answer the following questions correctly to obtain your CME.

Web Links/References

Classification

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