This is my second week volunteering in the OR, and now that I come in the morning, I get a chance to see a wide variety of cases. This week I observed a part of an aortic valve replacement procedure. The surgeons were busy with their work, but the anesthesiologist showed me his ultrasound machine that, it turned out, was an integral part of the procedure.
GE Healthcare has created the Vivid Cardiovascular Ultrasound System that gives anesthesiologists unprecedented capabilities for evaluating the heart and other organs. The device used at this OR was the Vivid 4 model. It has a probe that is inserted into the esophagus to show the coronal view of the heart, and into the stomach to show a horizontal view. A large monitor shows the imaged region in real time, which allows to evaluate the mechanical function of the valves and the myocardium (heart muscle). For example, I saw that the aortic valve was opening very poorly, a condition called aortic stenosis. A very cool feature that adds to evaluation and diagnosis is doppler. This allows to monitor blood flow inside the heart. As seen in the image; the blood flow is color coded according to velocity (but it might be mass flow). The heart
I saw, had a clear flow back into the left atrium as the AV valves were closing, which is termed ventricular regurgitation. Besides giving different viewing capability, this machine allows to make measurements. In this procedure it is important to determine the size of artificial valve to be inserted, and that was done by measuring the width of the aortic opening in mm.image source: GE Healthcare (www.gehealthcare.com)
To make a final comment, I learned that contact lenses and OR environment do not mix. My eyes were getting irritated from the dry air and from smoke caused by bowie (if spelled wrong let me know) knife. Also, here are images of the three general planes used in medical imaging.
image source: National Institute of Technology and Evaluation
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