June CASE: Just Useful, Noteworthy Examples

The latest issue of CASE is now available with intriguing reports, including “Point-of-Care Ultrasound for Guiding Pulmonary Artery Catheter Placement.” CASE Editor-in-Chief Vincent Sorrell, MD, FASE, remarked, “Su et al. provide readers with an outstanding use of POCUS to guide the placement of invasive hemodynamic catheters. In this report, they demonstrate the feasibility of using echo in place of fluoroscopy and include their insights from their learned experiences. They emphasize that this can be performed by a single operator with skills in both POCUS and catheter placement. They highlight the value added from this POCUS approach that includes not only the feasibility, rapidity of a bedside approach, simplicity of resource utilization and lack of radiation, but also in troubleshooting. In their CASE example, they used direct visualization on POCUS to address looping of the catheter within the RV that was managed through a process of balloon deflation and image-guided manipulation. Subsequently, they used POCUS to reposition the catheter tip from the LPA to the RPA to successfully obtain a PCWP that was initially not possible. The authors include a series of POCUS images and associated drawings matched to their step-by-step protocol for readers to use.” 

Also included in the Critical Care Echocardiography category is a report on the value of complementing serial bedside POCUS with consultative echo in Han et al.’s surgical approach to a critically ill patient managed in the ICU. Interventional Echocardiography presents a case of detailed figures and expert insights on the role of 3D TEE multiplanar reconstruction to guide transcatheter edge-to-edge repair of a complex mitral valve pathology. In a new category, Treadmills, Bikes, and Drugs, Okafor et al. demonstrate the many benefits of administering ultrasound enhancing agents during stress echo. Maligireddy et al. share their Congenital Heart Disease case, which combines 2D TTE with color flow and pulsed-wave spectral Doppler to reveal an unusual finding in a young patient recently diagnosed with Hodgkin lymphoma. Rounding out this issue is a Veterinary Clinical Cardiovascular Medicine case from Bentley et al., using conventional 2D and 3D TTE to assess a bicuspid aortic valve in a healthy cat. 

Dr. Sorrell’s editorial takes readers on a fun journey of acronyms used in cardiology clinical trials and includes a reading list of a few said trials. Be sure to check out the newest Unlock the CASE and Sonographer Sound-Off on the CASE homepage. 

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