TAVR Performed At UCLA First In The USA

One of the many diseases we echocardiographers find when we examine a patients heart is aortic stenosis. Aortic stenosis results when the aortic valve leaflets are unable to open properly allowing blood to flow from the heart to the body with vital oxygen. Aortic stenosis (AS) is fairly common and can seriously affect a persons life by limiting physical activities.   Symptoms such as shortness of breath, syncope, and peripheral edema are common.  Until recently, open heart surgery to replace the damaged aortic valve had to be performed to alleviate the most serious form of this cardiac valve disease.  Now, doctors at UCLA have performed a successful minimally-invasive aortic valve replacement on a human. Enjoy the link!




http://medicalxpress.com/news/2012-08-ucla-device-aortic-valve-patients.html

(Medical Xpress) -- UCLA has performed its first transcatheter aortic valve replacement (TAVR), using a new device approved by the U.S. Food and Drug Administration to replace an aortic valve in a patient who was not a candidate for open-heart surgery. The procedure took place on Aug. 9.

Read more at: http://medicalxpress.com/news/2012-08-ucla-device-aortic-valve-patients.html#jCp

Ronald Reagan UCLA Medical Center is part of a growing trend of hospitals nationwide offering this new minimally invasive procedure. As the U.S. population ages, an increasing number of patients will develop aortic stenosis, a narrowing of the heart's aortic valve caused by calcium deposits, which impedes blood flow, causing the heart to work harder to pump blood to the body and placing patients at higher risk of heart failure or death.

Read more at: http://medicalxpress.com/news/2012-08-ucla-device-aortic-valve-patients.html#jCp

Ronald Reagan UCLA Medical Center is part of a growing trend of hospitals nationwide offering this new minimally invasive procedure. As the U.S. population ages, an increasing number of patients will develop aortic stenosis, a narrowing of the heart's aortic valve caused by calcium deposits, which impedes blood flow, causing the heart to work harder to pump blood to the body and placing patients at higher risk of heart failure or death.

Read more at: http://medicalxpress.com/news/2012-08-ucla-device-aortic-valve-patients.html#jCp

Ronald Reagan UCLA Medical Center is part of a growing trend of hospitals nationwide offering this new minimally invasive procedure. As the U.S. population ages, an increasing number of patients will develop aortic stenosis, a narrowing of the heart's aortic valve caused by calcium deposits, which impedes blood flow, causing the heart to work harder to pump blood to the body and placing patients at higher risk of heart failure or death.

Read more at: http://medicalxpress.com/news/2012-08-ucla-device-aortic-valve-patients.html#jCp

Retrospective Part Three

Note:  Many writers compose thoughts when they are not thinking.  I am one.  I am part of the cadre of writers who write when they do not really intend to write.  Thus I begin the third installment of Retrospective.  Please refer to this link to catch up on the story:

Ultrasound and Evolution: a Personal retrospective ( Part 2)

I Remember flying home on Brannif airlines after skiing in A-Bason with a nice lady who was a great skier that did not seduce me, or give me bath salts.  Bath salts were not known in the 70's.  A zombie was only in a movie.  My goal was to meet with the hospital administrator to explain my issues.  I had trepidations.  I was not trained to be a sonographer.  I failed.....

We met and I explained that I had no idea how to perform a sonogram.  "You did attend three days of instruction?"  He said.  "Of course"!  I replied.  I did not skip out.  He called the chief of Staff.

COS asked if I had any hands-on.

No.

Why not?

No machines.... (Nervous)  this CME event provided no hands-on.

Shuffling of feet...

"You will make yourself known to the Pathologist." (Drum roll)

Notes that here my stomach dropped to my Valves of Houston (look that one up medical students). Hodor

"A Pathologist deals with dead things." I said.

I met with the pathologist and we agreed to a structured regiment of anatomical training.  I was dealt a hand which included autopsies and sonograms.  Specifically, I would take a corpse out of the fridge, and work it on to a gurney, then dress it with white muslin for decorum.  I would then wheedle it up the elevator to my lab much to the guffaws of my fellows (they called me Doctor Frankenstein) whence I would perform a sonogram on the corpse and make notes and Polaroids of my findings. I used a "Sharpy" magic marker to point to interesting areas.  My notes in hand, I would wheel that corpse back down to the morgue and call the pathologist on the phone (Real phone) and announce I had performed the sonogram much to the delight of administration.  This was before HIPPA of course.

The pathologist always arrived with a touch of bourbon in her breath, but she was a relentless task master.  "What did you see?"

"A mass on the superior pole of the right kidney"

"Then poke it!" she said while she was running the bowel under the vent-a-hood.

"Use the scalpel.  that thing with the green plastic handle"!

OK.... (poke)...poke poke

"What is the contents of the mass?"

Yellow fluid.  Yeccch.   

Grats.... a renal cyst...

Moments later after we had taken the liver to the dissection table.....

The first time she showed me the common bile duct I was floored.  The CBD is connected to the gall bladder, a source of many ED visits.

Gall bladder disease is rampant in the USA and many modern countries. Gall bladder surgeries are a staple of a general surgeons pay-check.  I will post a separate article on gall bladder disease.

The CBD is only 3 mm wide in normal patients.  Pancreatic duct?  LOL.  I could not see Wirsungs duct when she showed it to me.  I have an admiration for pathologists.  They see things many people are not aware of.  We went on to examine the pancreas (Looks like a pork tenderloin to me), the liver, the spleen, and some fun stuff with ruptured aortic aneurysms.  Wonderful stuff for people in search of anatomical knowledge.  A look into the abdominal cavity of a human is a wonderful look at what God creates.  So pretty, compact, and elegant. 

Weeks went by.  My pathologist friend revealed to me many secrets to include the anatomical relationships of the organs of the abdomen, chest and cranium.  I will never forget finding my first gallstones.They looked like smurfs.  She laughed and said "These are very common".  Little did I know how correct she was.  She said "Fast food is a scourge, and is making people very sick."  This was back in the 70's.  How true her predictions were.

Next installment: the Heart.

Gizz note:  this blog is a labor of love, and is always a work in progress

3-D Fetus Sculpture

Just when you thought medical imaging had run out of novelty ideas, here we have yet another way to put a dent in your credit card courtesy of the Japanese: The 3-D Trophy Fetus!  In Japan, you can purchase a miniature resin replica of your intrauterine fetus rendered by a 3-D printer for only 1,250 dollars.  Currently, the technique involves a 3-D MRI of the gravid uterus rendered into the sculpture.  Can a 3-D ultrasound be far behind?

So, you’ve been trying for quite a while, and the delightful news arrives that soon you will have a small, squishy hybrid of you and your partner for your very own.

In glee, you go for a scan, clutch the ultrasound image to your heart –and probably immediately upload it to Facebook.

But what if you could have a 3D model of your growing bundle of joy?

In Japan, this dream is now a reality due to three dimensional printing technology. Japanese firm Fasotec, in collaboration with Parkside Hiroo Ladies Clinic in Mintao-ku, Tokyo, have come up with a product to fill this niche for, er, consumer demand — and have called it “Shape of the Angel”.

Thanks Sonoworld and SmartPlanet

http://www.smartplanet.com/blog/smart-takes/printing-takes-a-creepy-turn-a-3d-replica-of-your-fetus/28092