Nikolay Dranishnikov, MD

Cardiac Anesthesiologist at @dhzcharite HEMS Physician at @DrfLuftrettung

[Nikolay Dranishnikov, MD @NDranish]

@alex1708ander 57 deg, so ME Mitral Commissural View. the left immobilized leaflet will be the medial one 💙

[Nikolay Dranishnikov, MD @NDranish]

@Mghori65 @alex1708ander @NMerke @Myn0lf @danimilovanovi1 @EvgenijVPotapov no, it is not a thrombus

[Nikolay Dranishnikov, MD @NDranish]

#echofirst Quiz: What is it and how did it get into the LV?
Hint: The Patient was last 2 weeks on Impella 5.5
#echoquiz

@alex1708ander @NMerke @Myn0lf @danimilovanovi1 @EvgenijVPotapov

[Nikolay Dranishnikov, MD @NDranish]

@alex1708ander maybe first close the VSD?

[Nikolay Dranishnikov, MD @NDranish]

@danimilovanovi1 @echocardiac @EchofirstB @donoxorn how did they solve it? a bypass on LCx after MVR?

[Nikolay Dranishnikov, MD @NDranish]

@danimilovanovi1 @alex1708ander @NMerke @JCVAonline @mahmoudkeshk83 @poktintang @AmadeuBertuol @KasbariN great point! IMO it could also be crucial in cases with direct ostial cardioplegia needed. The LCx ostium would be the 3rd one and can easily be missed.

[Nikolay Dranishnikov, MD @NDranish]

Who knows what we see in the aorto-mitral curtain on #echofirst in this patient with an acute aortic dissection? #echoquiz
@alex1708ander @NMerke @JCVAonline

[Nikolay Dranishnikov, MD @NDranish]

Incidental #echofirst finding in a Pt. with acute aortic dissection: an anomalous retroaortic LCx originating from the right aortic sinus, recently highlighted by @CASivaram1.

@alex1708ander @NMerke @danimilovanovi1 @iceman_ex @echo_stepbystep @iamritu @DirkEggert

[Nikolay Dranishnikov, MD @NDranish]

further images coming tomorrow!

[Nikolay Dranishnikov, MD @NDranish]

@stephietweetss @alex1708ander @NMerke @JCVAonline not the CS, but it is a vessel indeed

[Nikolay Dranishnikov, MD @NDranish]

An aneurysmal interatrial septum (IAS) adds complexity to RVAD management in mechanically ventilated patients. #echofirst shows why.

@alex1708ander @NMerke @EvgenijVPotapov

[Nikolay Dranishnikov, MD @NDranish]

@TheRadiodocs @alex1708ander we use Swan Ganz PA Katheter pretty offen in our ORs an almost never habe fluoro avaliable to control the process. #echofirst TOE is very useful and is almost always available.

[Nikolay Dranishnikov, MD @NDranish]

@alex1708ander Wow great, Alex! 2️⃣:0️⃣ for #echofirst before introducing the Swan Ganz.

[Nikolay Dranishnikov, MD @NDranish]

Unexpected finding in #echofirst TOE pre Heart-TX. I had a strange feeling and didn’t introduce the Swan-Ganz blindly in the induction room, probably avoiding fatal PE.

Do you always check for intracardiac thrombi before putting the Swan-Ganz in?

[Nikolay Dranishnikov, MD @NDranish]

72yo patient with a giant aortic root aneurysm 27 years post mech. AVR.
- Acute decompensation
- Bedside ECLS Implantation
- Too unstable for a CT Scan
- #echofirst in the OR

[Nikolay Dranishnikov, MD @NDranish]

Intraoperative TOE #echofirst reveals a relevant consequence of an #ecmo canula re-positioning, causing change of the surgical strategy during a #LVAD-Implantation.
#ecmo #ecls #FOAMecmo #foamcc
@alex1708ander @NMerke @EvgenijVPotapov @JCVAonline @SCVA1997

[Nikolay Dranishnikov, MD @NDranish]

It's all about perspective. Allways try to look multi-plane!
#echofirst

[Nikolay Dranishnikov, MD @NDranish]

@NajiLehbibMD @NMerke @ASE360 @BSEcho @YoungDgk @iamritu @rajdoc2005 @donoxorn Stanford Type A Dissection, Entry in proximal aortic Arch, no significant AR.

[Nikolay Dranishnikov, MD @NDranish]

@KU_CCM @JCVAonline @PulmCrit @CriticalCareNow @ColumbiaCCM @SOCCA_CritCare the scale of the PAP curve needs more range.. it would demask a significant difference in RV-Strokevolume