Alexander Mladenow MD
@alex1708ander
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Pediatric & Adult Cardiothoracic Anesthesia | 💉🫀Echocardiography | EACVI Board certified in TEE, TTE and CHD Echo @dhzcharite 🇩🇪#echofirst #3D Education
Berlin
Joined April 2022
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Check out a video walkthrough of an outlet #VSD
https://t.co/vO3dnW2X8T Outlet VSDs are found in the "Y" of the septal band aka between the cranial and caudal limbs of the septomarginal trabeculation. #pedsicu #anatomy #pathology #chd #pediatrics #cardiology #heart
👉🏻 In Posterior malalignment VSD (outlet septum) always look for associated CoA. 👉🏻BAV (80%) is the most common associated cardiac abnormality in CoA. @AEPCcongenital @iamritu @CASivaram1 @alex1708ander @WithAScalpel @loomba_rohit @DavidWienerMD @SIwa23288585 @EACVIPresident
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@alex1708ander Totally agree. This is the surgeon’s view:
VSD Patch Closure — #1 Anterosuperior Portion (Surgeon’s View): The VSD patch is gently parachuted onto the anterior rim using a backhand. As the suture reaches the transition between the ventriculoinfundibular fold and the anterior limb of the TSM, the surgeon shifts to a
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Normal coronary ostia after arterial switch operation (ASO) for d-TGA #echofirst Intraop TEE, 10T-D micro probe, patient weight 3.1 kg
Coronary ostia in malposition of the great arteries (MGA) in TEE #echofirst To understand how to find them in MGA, just slit into the anterior PV leaflet facing the AV and spread your arms. The PV leaflet, the most distant from the AV is the anterior one. It’s mirrored to NCC
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As President of the EACVI, it is my great pleasure to welcome our global cardiovascular imaging community to Vienna for #EACVI2025. On Thursday, thousands of clinicians, scientists, and innovators will come together to share knowledge, advance excellence, and shape the future of
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The surgical approach for a perimembranous VSD closure is the RA - the VSD lies below the anterior & septal TV leaflets #echofirst 👉 understanding the surgical anatomy is crucial for the imager 👉 understanding the echo image is crucial for the surgeon
Very important message from @OungSavly. And, a key tip for closing a posterior malaligned VSD: place the VSD patch sutures slightly more toward the LV side (point C) to help open the LVOT (modified image from @OungSavly).
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6-week-old infant, admitted for respiratory distress. @WGACHDChair @iamritu @CASivaram1 @DavidWienerMD @alexsfelixecho @loomba_rohit @DrJenniferCo_Vu @alex1708ander @SIwa23288585 @WithAScalpel
👉🏻 In Posterior malalignment VSD (outlet septum) always look for associated CoA. 👉🏻BAV (80%) is the most common associated cardiac abnormality in CoA. @AEPCcongenital @iamritu @CASivaram1 @alex1708ander @WithAScalpel @loomba_rohit @DavidWienerMD @SIwa23288585 @EACVIPresident
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Coronary ostia in malposition of the great arteries (MGA) in TEE #echofirst To understand how to find them in MGA, just slit into the anterior PV leaflet facing the AV and spread your arms. The PV leaflet, the most distant from the AV is the anterior one. It’s mirrored to NCC
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MV replacement 🔄 in MIC approach for native MV endocarditis 🦠 #echofirst Intraop ✅ Pre-TEE ✅ in between TEE (🫀starts beating again) ✅ post-TEE Time span between first and last echo loop - 1 h But MV is not the only piece of the 🫀…we need to 👀 with TEE
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👉🏻 In Posterior malalignment VSD (outlet septum) always look for associated CoA. 👉🏻BAV (80%) is the most common associated cardiac abnormality in CoA. @AEPCcongenital @iamritu @CASivaram1 @alex1708ander @WithAScalpel @loomba_rohit @DavidWienerMD @SIwa23288585 @EACVIPresident
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Arterial Switch Operation for d-TGA. 👉 Look how the pulmonary artery bifurcation overrides the ascending aorta 👉 Jatene + LeCompte maneuver
Intraop TEE (postprocedural) in a pediatric patient with CHD - what kind of surgery was done? #echofirst @DrRajeshG1 @OungSavly
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Intraop TEE (postprocedural) in a pediatric patient with CHD - what kind of surgery was done? #echofirst @DrRajeshG1 @OungSavly
Echo quiz for fellows. This patient had a surgery in childhood, what surgery?
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This is what we usually see on the intraop TEE immediately after #TOF-repair - at least moderate PR but mostly even more than moderate #echofirst In this patient PHT PR is 77 ms - according to the guidelines it’s a severe PR (< 100 ms) @KemalogluOz
Echo quiz for fellows. This patient had a surgery in childhood, what surgery?
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Prominent Eustachian Valve (green arrow) mimicking a Cor Triatriatum Dexter intraop #3DTEE #echofirst Adult patient with CTEPH undergoing surgical PEA 👉 right-to-left shunt (bubbles 🫧) across a PFO (red arrow) 👉 pulmonary artery catheter (violet arrow) seen in RA & RV
10-month-old, 8kg. Cortriatriatum Dexter vs Prominent EV.@AEPCcongenital @EACVIPresident @ASE360
@WGACHDChair @iamritu @escardio @dkthekkoott @CASivaram1 @alexsfelixecho @echoleolopez @DavidWienerMD @alex1708ander @loomba_rohit @swatigar @SIwa23288585 @WithAScalpel @CardioNeo
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Pediatric patient with LVOTO in #3DTEE This is what we call “clocking” in echo - it will help you #echofirst to better understand how 2D images correspond to 3D imagin:ation LVOTO = LVOT obstruction = subaortic ridge
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In this case #Impella first #echofirst Why? - on admission the patient is hemodynamic and respiratory unstable and most likely would not survive an immediate MV surgery - (CPB, heart standstill..) Surgery could be postponed till the patient stabilizes on #Impella
The patient is intubated and needs inotropic support on admission RegVol MR = 80 ml Reg Fr = 61 % 👉 how would you proceed #echofirst? 👉 what do you expect would happen if you directly go for MV surgery? 👉 is LVEF a relevant parameter in this setting? #volumetrics
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#3EchoBerlin #echofirst workshop 👊 Program https://t.co/ZCUnbMa1su 👊 Register here https://t.co/mVeCyvEPGS 23 CME points to gain
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The patient is intubated and needs inotropic support on admission RegVol MR = 80 ml Reg Fr = 61 % 👉 how would you proceed #echofirst? 👉 what do you expect would happen if you directly go for MV surgery? 👉 is LVEF a relevant parameter in this setting? #volumetrics
Severe MR in a patient suffering an acute myocardial infarction #echofirst ✅ FlexiLight ♻️ Cropping 3D Dataset ❇️ 3D frame rate ~ 2D frame rate ❇️ 28 fps (3D) 🆚 29 fps (2D) If you want to learn more 👉register here https://t.co/HVi8nIE1KK
@NMerke #3DechoWorkshop Berlin 2026
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