QLab for TAVR

[35005]

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I'm twenty years into private practice and the surgeons I work with have asked our group to become proficient in 3D sizing of the aortic annulus for TAVRs. Anyone recommend a good source for how to best accomplish this? We will be using the Epiq system and I would like to get a jump start on reading.

Thanks everyone.

 

[anes121508]

I'm twenty years into private practice and the surgeons I work with have asked our group to become proficient in 3D sizing of the aortic annulus for TAVRs. Anyone recommend a good source for how to best accomplish this? We will be using the Epiq system and I would like to get a jump start on reading.

Thanks everyone.

SCA has workshops for this type of stuff. This year they had a workshop on it. Not sure if echo week does as well but I'd imagine it does. YouTube has a few videos if you search 3D echo. There are a few papers out there on it if you
Google it, but they aren't that great. If
You PM me, I can send you a few other things that may help guide you through it step by step. There is no substitute though for just sitting down and playing with qlab to get oriented with the program.

While we are on this topic...how many of you guys/gals are being asked to do this?

All femoral are done with sedation and they use CT to size the annulus where I am from.

 

[ProRealDoc]

I'm twenty years into private practice and the surgeons I work with have asked our group to become proficient in 3D sizing of the aortic annulus for TAVRs. Anyone recommend a good source for how to best accomplish this? We will be using the Epiq system and I would like to get a jump start on reading.

Thanks everyone.

Assuming you're proficient with TEE, I suggest spending an afternoon with the Phillips Rep going over Qlab. I use it to calculate EF and strain regularly on an old IE33. I don't think EPIC should be that much different.

 

[bigdan]

Also - if you guys recently bought an Epiq, ask Philips to send you to a (fully-Philips-sponsored) education session. Almost assuredly, you have purchased an education package along with the machine and probes. I think all of the education sessions are focused on 3d, including one on structural heart.

Of perhaps more importance, you might want to look into why they are not using the CT measure for sizing.

 

[sevoflurane]

We do it a lot. We are 60:40 asleep vs sedation. All asleep cases get TEEs with annulus measurements.

Decently high volume. 6 TAVRS this past Monday.

 

[sevoflurane]

Agree with above. Get the phillips guys to come out and help. Also, some of the Edwards reps have some descent knowledge on acquirering measurements.

 

[DrBeaker]

We do it a lot. We are 60:40 asleep vs sedation. All asleep cases get TEEs with annulus measurements.

Decently high volume. 6 TAVRS this past Monday.

What time did that room finish? Did 3 the other day, all MAC. 8ish hour day

We try and do TF with MAC, and use CT measurement. But if there is any question of valve size or converting to TA, they get GA and a TEE

 

[sevoflurane]

What time did that room finish? Did 3 the other day, all MAC. 8ish hour day

We try and do TF with MAC, and use CT measurement. But if there is any question of valve size or converting to TA, they get GA and a TEE

Finished 6 by 18:00. This was unusual for our program.
We usually schedule 4 TAVRs and are done before 15:00.
Sometimes longer sometimes shorter, but usually done before 15:00.
Extremely streamlined process.
We are not shy to do them under light GA due to patient related issues, poor quality CT, potential access issues or need for us to insert pre TAVR temporary transvenous pacers in high risk patients that may go into complete heart block post TAVR.

 

[sevoflurane]

We also have an interventional cardiologist and a CT surgeon working side by side during these cases.