FIGURE LEGENDS
Figure 1. Modified mid-esophageal 4-chamber two-dimensional TEE
view obtained prior to cannulation demonstrating severe left ventricular
dilation and increased sphericity. LV: left ventricle, MV: mitral valve,
RV: right ventricle; TEE: transesophageal echocardiography
Figure 2. Live three-dimensional (3D) TEE image obtained during
positioning of the venous cannula across the interatrial septum (IAS)
used for guidance and as the source image to perform multiplanar
reconstruction to measure the distance the cannula tip extended across
the IAS. AV: aortic valve; TEE: transesophageal echocardiography; TV:
tricuspid valve.
Figure 3. Live 3D TEE image of the final cannula tip position
within the left atrium (LA). The green line displays the measured
distance of the cannula across the IAS (43mm) projected onto
three-dimensional space. This measurement was obtained using multiplanar
reconstruction for optimal plane alignment just as performed on the
ultrasound system in the catheterization lab at the time of cannulation
(see Figure 5). .Other abbreviations as in previous figures.
Figure 4. Live 3D TEE image projected to demonstrate a basal
view of the heart aligned in anatomical position to demonstrate the
course of the venous cannula across the IAS. Abbreviations as in
previous figures.
Figure 5. Multiplanar reconstruction of a 3-D dataset (Figure 2
demonstrates original 3-D capture) demonstrating plane alignment on the
venous cannula used to accurately measure the distance the cannula tip
projected into the LA. Abbreviations as in previous figures.
Figure 6. Nonstandard TEE window demonstrating final position
of a 23F Multistage Venous Cannula with color Doppler flow noted at the
distal tip and side ports after initiation of left atrial veno-arterial
(LAVA)-ECMO. Abbreviations as in previous figures.