Here is the TV with the patient supine. Huge credits to our second yr trainee , who thought of imaging supine as well . Native valve , could this be positional obstruction ? 3/

Here is the TV when the patient is in left lateral 2/

Interesting case of obstruction across the TV in left lateral position ? Has anyone seen this before . B/g ongoing .SOB and hypotension. Moderately dilated root and asc. 1/ .@echoguru @echo_batman @bwoody58 @agathakwon @Becho2106 @kaznegishi @BeardedHeartDoc

Any thoughts on this late systolic septal dyskinesis post exercise ? Coronaries - normal. Is this benign , or some form of exercise induced conduction system abnormality? @echoguru @echo_batman @kaznegishi @agathakwon @iamritu @bwoody58

I’m looking forward to presenting on the Aortic valve. Diving beyond the guidelines to explore flow rate and discordance in AS. We will also address the challenges in grading PVL’s post-TAVR . ⁦@GEHealthCare⁩.

@echoguru @iamritu @echo_batman @bwoody58 @echo_stepbystep @kaznegishi @BeardedHeartDoc @NMerke Edit ** .SV (1.9cm) - 65ml .SV (2.6cm) - 122 ml.

@echoguru @iamritu @echo_batman @bwoody58 @echo_stepbystep @kaznegishi @BeardedHeartDoc @NMerke Total SV - 40 ml .Effective SV - 83-143 ml ( depending on LVOTd) .CO on Cath - 3.0 l/ min .Do you think this is likely a case of low stroke volume ?.

Predicted LVOTd - 1.9 cm , SV - 83 ml .LVOtd - 2.5 cm , SV - 143 ml .How would you report ? .@echoguru @iamritu @echo_batman @bwoody58 @echo_stepbystep @kaznegishi @BeardedHeartDoc @NMerke.

Another AS dilemma . BSA 1.33. AV Vmax - 3.5 , MG - 32 mmHG . AVA - 1.2 cm2 , DVI - 0.28 . Aortic root - 3.6 cm , asc aorta - 4.4 cm . Is the LVOTd dilated ? We got 2.5 - 2.6 cm . Invasive Cath shows AVA - 0.6 cm2 . What is the true severity of the AS ? . #reallifeAS

3 m post op - valve gradients similar to baseline . PVL now looks mild+ . No Flow reversal. SBP similar. what do you think is going on ? I’ve observed PVLs usually getting worse overtime , so this is a first. @echoguru @iamritu @NMerke @echo_batman @bwoody58 @echo_stepbystep

Has anyone seen significant PVL post TAVI resolve ? If yes , what is the physiology behind this . See case below . Post op - SBP 130 . Normal valve gradients , at least moderate PVL . Difficult post op imaging , inadequate vis of desc Ao . 1/

Excellent @ASE360 AR Part 1 session. Thanks to all the panelists . Highlighting the importance of AR criteria that are both specific and sensitive vs criteria that are only specific and not sensitive .#echofirst

Can you say that if there is HV pan sys FR that the TR is severe ? Apart from arrhythmias, are there other clin presentations that can cause HVFR. Looking for mimics of sev TR and why @echoguru @NMerke @kaznegishi @KemalogluOz @Becho2106 @agathakwon @BeardedHeartDoc @echo_batman.

Our case has been published in @CASEfromASE . Such a supportive group to write with. Thanks for the opportunity @VLSorrellImages . Thanks to all the authors #MQHealth @Macquarie_Uni #echofirst.

First thoughts - high LVOT vel - without the septal bulge could this be underlying low flow ? .LVOTd measured and predicted = 2.1 cm , BSA - 1.58 .Normal LVEF and GLS.AVA - 1.95 cm2 . Or is this just not true moderate or severe AS ?

Confusing case of mod/sev AS. Valve looks calcified but the gradients are discordant . Keen to know everyone’s thoughts @Becho2106 @echoguru @KemalogluOz @sturwohld @RobChamb87 @NMerke @echo_stepbystep @BeardedHeartDoc @kaznegishi 1/

Case 2 - 26 mm BEV AVA-1.9 , AVAi - 0.95 , DVI - 0.36 , AT - 111 ms , CWD parabolic , Norm SVi , triv PVL . Thoughts on - AT , vel and shape of CWD traces bet the 2 cases.@echoguru @sturwohld @Becho2106 @dr_benoy_n_shah @iamritu @NMerke @echo_batman.

2 interesting post TAVR cases , would you be concerned with any of these measurements .1 - 29 mm BEV , AVA - 1.7 , AVAi - 0.85 , DVI - 0.34 , AT - 55 , CWD looks early peaking . Normal SVi , trivial PVL

What a fun way to learn about ⬆️wall thickness @Becho2106 . Sorry I missed this live. Some really important factors to think through in patients with ⬆️wall thickness, also excellent detail on diastology .@asasonography .Good one to use at your lab study sessions !.

This will be a good session !.