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Beyond basic echo anatomy #echofirst 🌟Elevating the way we see the interatrial septum in TEE 🥽 The interatrial septum is more than anatomy 🫀- it’s a procedural roadmap📍 TEE guidance for: 1️⃣ M-TEER (transseptal puncture) 2️⃣ PTC of ostium secundum ASD

Alexander Mladenow MD

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15,572 次观看 • 1 个月前 •via X (Twitter)

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Apical 4-chamber view: a single window that maps cardiac anatomy and relationships. How to obtain it: 🔵 Place the transducer at the point of maximal impulse (LV apex) 🔵 Keep the probe index marker directed toward the patient’s left side (≈3 o’clock) 🔵 Aim the beam toward the base of the heart (toward the right shoulder) 🔵 Fine-tune tilt/rotation until all four chambers are symmetric and the septum is vertical From the LV apex, you see all four chambers in one plane (LV, RV, LA, RA) with correct orientation (apex near the probe, atria deeper). Key structures: 🔵 LV: papillary muscles, chordae, anterior & posterior mitral leaflets 🔵 RV: moderator band, anterior & septal tricuspid leaflets 🔵 Interatrial septum and ventriculoatrial septum (LV–RA separation) 🔵 Right superior pulmonary vein entering the LA near the septum 🔵 Descending aorta seen posterior/lateral to the LA High-yield pearl: The tricuspid valve annulus is normally positioned more apically than the mitral, an important landmark in structural assessment.

Apical 4-chamber view: a single window that maps cardiac anatomy and relationships. How to obtain it: 🔵 Place the transducer at the point of maximal impulse (LV apex) 🔵 Keep the probe index marker directed toward the patient’s left side (≈3 o’clock) 🔵 Aim the beam toward the base of the heart (toward the right shoulder) 🔵 Fine-tune tilt/rotation until all four chambers are symmetric and the septum is vertical From the LV apex, you see all four chambers in one plane (LV, RV, LA, RA) with correct orientation (apex near the probe, atria deeper). Key structures: 🔵 LV: papillary muscles, chordae, anterior & posterior mitral leaflets 🔵 RV: moderator band, anterior & septal tricuspid leaflets 🔵 Interatrial septum and ventriculoatrial septum (LV–RA separation) 🔵 Right superior pulmonary vein entering the LA near the septum 🔵 Descending aorta seen posterior/lateral to the LA High-yield pearl: The tricuspid valve annulus is normally positioned more apically than the mitral, an important landmark in structural assessment.

CardiovascularCorner

12,333 次观看 • 4 个月前

👇Transseptal Complication: Aortic Injury👇 The patient was transferred from another hospital due to an aortic injury. During the initial procedure, the clinician inadvertently punctured the aorta. In a moment of panic, the sheath was advanced—an action that should never be taken in such circumstances—before transferring the patient to our facility. Upon arrival, we carefully retracted the sheath under guidewire support, prepared for thoracotomy if needed. Subsequent angiography and TEE assessments revealed no evidence of a shunt or bleeding. Fortunately, this severe complication was resolved without the need for surgical intervention. Key Lessons: 👉 1. Always puncture posteriorly; the left atrium is located in the posterior aspect. 👉 2. Remain calm; never advance the sheath into the aorta. 👉 3. Do not retract the guidewire until ruling out any shunt or bleeding🚨🚨 👉 4. Transseptal puncture should be performed or supervised exclusively by experienced clinicians🚨🚨 👉 5. For challenging anatomical conditions, TEE or ICE guidance is highly recommended🚨🚨 Philipp Sommer Christian Sohns Martin Braun Moneeb Khalaph Vanessa Sciacca Maxim Didenko, MD PhD FESC FEHRA @AleSpoken AGEP Young DGK #EPeeps #CardioTwitter

👇Transseptal Complication: Aortic Injury👇 The patient was transferred from another hospital due to an aortic injury. During the initial procedure, the clinician inadvertently punctured the aorta. In a moment of panic, the sheath was advanced—an action that should never be taken in such circumstances—before transferring the patient to our facility. Upon arrival, we carefully retracted the sheath under guidewire support, prepared for thoracotomy if needed. Subsequent angiography and TEE assessments revealed no evidence of a shunt or bleeding. Fortunately, this severe complication was resolved without the need for surgical intervention. Key Lessons: 👉 1. Always puncture posteriorly; the left atrium is located in the posterior aspect. 👉 2. Remain calm; never advance the sheath into the aorta. 👉 3. Do not retract the guidewire until ruling out any shunt or bleeding🚨🚨 👉 4. Transseptal puncture should be performed or supervised exclusively by experienced clinicians🚨🚨 👉 5. For challenging anatomical conditions, TEE or ICE guidance is highly recommended🚨🚨 Philipp Sommer Christian Sohns Martin Braun Moneeb Khalaph Vanessa Sciacca Maxim Didenko, MD PhD FESC FEHRA @AleSpoken AGEP Young DGK #EPeeps #CardioTwitter

El Hamriti Mustapha

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The New Hash AI Roadmap is Here! We’re excited to unveil the future of Hash AI- it’s bigger, bolder and more ambitious than ever. Our vision for 2025 and beyond is clear: deliver more value to our holders and unlock powerful new utility for the $HASHAI token. This new roadmap is a statement of our commitment to innovation, real-world utility, and the long-term growth of the Hash AI ecosystem. Join us as we explore the limitless possibilities of AI and shape the future of crypto mining.

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Hash AI

87,927 次观看 • 1 年前

Are you agile on the sagittals?? Sagittal T1 images are for anatomy, but only if you know how to use them! Here is how I remember the sagittal anatomy 1. Start lateral 2. Find the gyrus that looks like a triangle, that is the pars triangularis of the inferior frontal gyrus 3. In front of it is the pars orbitalis—easy it’s over the orbit 4. Behind it is the pars opercularis. Remember oper sounds like OVER so its OVER the sylvian fissure 5. Behind the pars opercularis is the precentral gyrus 6. Right behind the precentral is the post central—duh post follows pre! 7. Behind the post central is the supramarginal gyrus. Remember supra means above, so it’s above the sylvian fissure. Margin = at the posterior margin of the sylvian fissure 8. Behind the supramarginal gyrus is the inferior parietal lobule. Remember inferior is below supra, so inferior parietal lobule is below the supramarginal 9. More medial is the lateral orbital gyrus. It’s easy, it above the orbit! 10. Even more medial is the gyrus rectus. Rectus means straight, so if you see a gyrus that is straight like a line, that is the gyrus rectus! Hopefully this gives you a handle on the sagittal! Stay tuned for the midline sagittal anatomy!!

Are you agile on the sagittals?? Sagittal T1 images are for anatomy, but only if you know how to use them! Here is how I remember the sagittal anatomy 1. Start lateral 2. Find the gyrus that looks like a triangle, that is the pars triangularis of the inferior frontal gyrus 3. In front of it is the pars orbitalis—easy it’s over the orbit 4. Behind it is the pars opercularis. Remember oper sounds like OVER so its OVER the sylvian fissure 5. Behind the pars opercularis is the precentral gyrus 6. Right behind the precentral is the post central—duh post follows pre! 7. Behind the post central is the supramarginal gyrus. Remember supra means above, so it’s above the sylvian fissure. Margin = at the posterior margin of the sylvian fissure 8. Behind the supramarginal gyrus is the inferior parietal lobule. Remember inferior is below supra, so inferior parietal lobule is below the supramarginal 9. More medial is the lateral orbital gyrus. It’s easy, it above the orbit! 10. Even more medial is the gyrus rectus. Rectus means straight, so if you see a gyrus that is straight like a line, that is the gyrus rectus! Hopefully this gives you a handle on the sagittal! Stay tuned for the midline sagittal anatomy!!

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#TeamBestie from the red carpet of the NYC premiere! Queen of the Ring is more than just a movie—it’s a powerful tribute to the women who fought for their place in the ring. As two women who’ve lived that journey, it’s incredible to see their stories on the big screen, especially as we celebrate International Women’s Day. This film, the true story of Mildred Burke’s rise to pro wrestling superstardom is a must-see for every fan of women’s wrestling and beyond! In theatres nationwide TOMORROW! #QueenOfTheRing

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The anatomy of a neo-colonial tourist economy. 🧵 In the thread below, we exposed the narrative attack. Now, look at the economic reality behind the scenes of this second video: 1️⃣ A foreign-owned Riad extracting the capital. 2️⃣ Underpaid sub-Saharan labor providing the service. 3️⃣ A binationale tourist extracting the "content." What exactly does the Moroccan citizen gain here? We finance the world-class infrastructure, the visa-free access, and security that enables this bubble, only to host visitors who act as digital proxies for a hostile neighboring agenda. They consume our resources, use our hospitality as a backdrop, and then wage cognitive warfare against our national brand. It is a one-way extractive model. Time to enforce true normative sovereignty. 🇲🇦 #Geopolitics #Morocco #Sovereignty #DigitalInfluence

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Did Lily think life is all about look? “NO! it’s like the least fun part of life! the way you look is the least important part of yourself, the inside of you is the most important. The society have made it so important when it’s never been all that. People can be so much more than their looks, people ARE so much more than their looks… However it’s cute to have like playing with makeup, style, that’s just for your self gratification, it’s not for other people, but sure getting compliments on the way look is always a good time, but at the end of the day, those are for yourself, don’t ever do that for anyone else, it’s never gonna end well, tho in this world is pretty much impossible especially with my job, but we have to try.”

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Sam Altman: "Very soon an AI will just be running for you in the background all the time" That entire model is on its way out. But the vision isn't the tell. This is: He says everyone's going to want "so much more of this AI infrastructure than we think." That's not a roadmap. That's a man admitting he can't build chips and power fast enough. The always-on assistant is the headline. The infrastructure bottleneck underneath it is the trade almost nobody is pricing in. That gap is the whole edge.

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