Alessandra Joslin

🇧🇷 MD; Cardiology; Echocardiography. Sao Paulo; Brazil. @hosp_einstein

[Alessandra Joslin @AleJoslin]

Percutaneous Balloon Mitral Valvuloplasty #echofirst

[Dr. Gilbert Tang @GilbertTangMD]

Want to know the new enhancements of the #MitraClip #TriClip G5 system over G4? Watch my new series of @YouTube videos on my Channel, under the MitraClip/TriClip G5 Playlist. It features a lecture and a series of short demo videos. @MountSinaiHeart is proud to be one of the first sites in the world to evaluate and adopt this new technology.
https://t.co/wLfzlL6id6

G5 vs G4 lecture:
https://t.co/iGjcgHBLPN

G5 demos:
https://t.co/32Y8wqZ2X4
https://t.co/dXCCBnZlg9
https://t.co/GUJtjgJf2m
https://t.co/8Qu46QwHAQ
https://t.co/dIwnXTIzTJ
https://t.co/tEW5HrnbBz
https://t.co/gOxjEJRQuW
https://t.co/OFeq5kYXRN

@AbbottCardio
@MountSinaiNYC
@IcahnMountSinai
@DoctorKini
@KHERA_MD
@LucySafi
@vonBardelebenRS
@modine_thomas
@hahn_rt
@kentso987
@MiChen__
@OKhaliqueMD
@azeemlatib
@AndreaScotti21
@SyedZaidMD
@TsuyoshiKaneko1
@m_taramasso

[Ritu Thamman MD @iamritu]

In Atrial Functional MR can get “Hamstringing”of posterior MV leaflet due to massive LA dilation;this “atriogenic” leaflet tethering is from displaced posterior annulus onto crest of LV inlet resulting in⬆️in annulopapillary distance restricting leaflet motion #echofirst

[Ritu Thamman MD @iamritu]

atrial functional mitral regurgitation📝
🔺Diastolic dysf, E/e′ ratio & LAVI ≥ 40 mL/m2 assoc w⬆️☠️not EOA
🔺AFMR presence more prognostic than EROA severity
🔺AFMR EROA orifice shape elliptical underestimates severity
🔺2/3 of pts w mod or >AFMR had AFib https://t.co/triYxKmfy1

[Sergio Moreno M @Serginho1409]

Review
Intraoperative Transesophageal Echocardiographic Guidance in
Cardiac Surgery https://t.co/8kBTpeGO59 #echofirst #Cardiology #iecho #CardioEd #EchoFirst

[AATS @AATSHQ]

A previously fit and well 25-year-old woman with headaches ended up being diagnosed with papillary fibroelastoma (PFE). Read the case report titled Sea anemone invades the heart: Unusual lesion of the mitral valve in #JTCVS Techniques: https://t.co/gH1AObEwWT

[Mounir Basalus (Ⲃⲁⲥⲓⲗⲓⲟⲥ) @Basalus]

1/ Strain Imaging in Echocardiography:
A powerful tool for detecting subtle myocardial dysfunction, far beyond LVEF.
Here’s why it’s transforming cardiology — and how you should be using it. A thread:
#CardioTwitter #Echo #FOAMed

[AATS @AATSHQ]

#TechniquesThursday: Researchers found robotic myxoma resection using an ultrasonic aspirator system is simple, safe, and reliable. Read more from Chibanishi General Hospital in #JTCVS Techniques: https://t.co/hYUnJyxHR6

[Mounir Basalus (Ⲃⲁⲥⲓⲗⲓⲟⲥ) @Basalus]

1/8
How often should patients with a bicuspid aortic valve (BAV) be monitored?
Let’s break down the latest guidelines to help prevent complications like aortic dilation, aneurysm, or dissection

[Nicolas Merke @NMerke]

#echofirst & MR
How to assess MR for proper decision making?

Follow standardized echo protocol answering the following 
questions:
❓ How much
❓Structural integrity 
❓Why 

How much MR is there?
👉GL do recommend PISA & regurgitation volume & fraction MANY PITFALLS (N. Merke)
👉 https://t.co/L75q5vYump
👉GL asking for vena contracta
👉indirect parameter as E- wave inflow velocity > 1,2 m/s & DVI > 1,4
👉Pulmonary vein inflow reduction or flow reversal
🎯look at LV volumes as a simple byproduct of LV EF a parameter we all believe in
🎯look at forward stroke volume another parameter we do believe in
🎯never forget to do quality check by looking at RVOT SV & RVSV (in isolated MR LVOT SV = RVOT SV = RVSV)

Structural Integrity
👉LVEDS?
👉LAVI?
👉sPAP

Why? 
Seen by 2D & 3D TTE first so often no need for TEE in diagnostic work up

TEE needed if TTE inconclusive or for interventional planning of therapy

SMR atrial vs ventricular
PMR
2D:
👉Look at leaflet position using Mitralvalve annulus as reference plane
🎯leaflets flat (atrial SMR)
🎯leaflets pointing towards left ventricle (ventricular SMR)
🎯leaflets pointing towards left atrium (primary MR)

Look at jet direction if eccentric or central

Eccentric jet
🎯jet direction is pointing away from prolapse
🎯jet direction is pointing towards the tethered leaflet
ventricular SMR or in case 
of restricted posterior leaflet atrial SMR

Central jet
🎯jet central in atrial SMR
🎯jet central in symmetrical tethered leaflets as in DCM ventricular SMR
🎯jet central in bileaflet prolapse in primary MR

Timing of jet (use Color M Mode)
🎯holosystolic in atrial and ventricular SMR
🎯late systolic in primary MR

3D
Using 3 apical views to achieve 3 datasets from the mitral valve including the. 👉entire valve apparatus, 👉landmarks as aortic valve, the left atrial appendage and the coronary sinus furthermore 👉avoid artifacts as air
Use atrial perspective to image leaflet movement and direction
🎯primary MR shows leaflet displacement towards left atrium by using translumination facilitate by showing shadow as hint for prolapse
🎯secondary MR shows leaflet flat or from ventricular perspective pointing towards left ventricle

Leaflet position in 2D & 3D, jet direction and jet timing will help to determine the WHY

Report:
Severe primary MR due to P2 Prolapse
LV SV ml, LVOT SV ml, Reg. Vol. ml, Reg. Fraction %
PISA not possible as jet is eccentric
Vena contracta
E wave > 1,2 m/s
LV / LA dilated
LV EF & GLS

Always quality check look at RV SV & RVOT SV

[Vladyslav Kavalerchyk 🇺🇦 @echo_stepbystep]

The 10 Things to know about RV Function & discussion 🗣️ @ManiVannanheart #3DEchoBerlin @iamritu
@denisamuraru @lpbadano @iamritu @DavidWienerMD
@JaeKOh2 @alex1708ander @alexsfelixecho @NMerke
@fiore_corrado

[Ritu Thamman MD @iamritu]

What’s in a name?
most patients with MAD actually should be called Pseudo-MAD (apparent systolic MAD) part of myxomatous degeneration assoc w curling Pickelhaube arrhythmias but not a true anatomical substrate which is seen in sys & diastole #echofirst https://t.co/cfdIr9EdNp

[Alessandra Joslin @AleJoslin]

@AntonioLJAraujo @RobinsonPoffo Thank you @AntonioLJAraujo

[Alessandra Joslin @AleJoslin]

#echofirst of an outstanding #davinci robotic mitral valve repair 🤖 🫀

🇧🇷👨🏼‍⚕️Great work performed by @RobinsonPoffo

[CardioNova @AppCardioNova]

A giant and double-walled left atrial ball thrombus complicating a mitral stenosis.

🔗DOI: 10.1093/ehjcr/ytac443
#echofirst #CardioEd #FOAMed

[Eric E. Roselli @EricRoselliMD]

Bicuspid aortic valve aortopathy can progress after valve replacement! This pt is 45 years post first op and 36 years post ball-in-cage AVR (still working) now with >5cm aneurysm #LifelongCare @ClevelandClinic #AortaCenter #StarrEdwards

[Ross Prager @ross_prager]

(1/x) Here are the 10 biggest errors I see clinicians make while trying to learn #POCUS

(aka: how to avoid common POCUS pitfalls)

A 🧵

[Ross Prager @ross_prager]

(1/x) A 'clot in transit' is a rare echo finding that when you see it, you might double guess yourself.

Finding a clot in transit can be a game changer for the management of pulmonary embolism 🫁🩸

A 🧵of clot in transit cases (with some important mimics)

[Jae K. Oh @JaeKOh2]

What an amazing skill and result of apical myectomy for #apicalHCM by @HSchaffMD ! Meticulously avoiding injury to papillary muscle. Presented at our annual #EchoNY. The procedure improves LV cavity size, LV filling pressure , and clinical outcome. @MayoClinicCVS @MayoClinicCV

[Alex Felix @alexsfelixecho]

@iamritu @ASE360 @VLSorrellImages @rajdoc2005 @NadeenFaza @NMerke @echo_stepbystep @DocStrom @purviparwani @onco_cardiology Great post and illustration, dear @iamritu 🌟🌟🌟
Many times in this kind of partial / distal cusp prolapse we find during surgical inspection also fenestrations, and sometimes very thin and friable leaflet tissue, imposing additional difficulty for repair.

[Mohamed Elsabah @mohamed_elsabah]

First case of trans septal Sapien valve in degenerated Tedyne valve from London, UK.
#EuroEcho2024
@ASE360
@KFAFHCards
@mirvatalasnag
@fayezbaraah
@YaserNemshah
@SACIS_KSA