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Fig. 2 | JA Clinical Reports

Fig. 2

From: Efficacy of intraoperative transesophageal echocardiography in a case of protamine shock during transcatheter aortic valve implantation

Fig. 2

Mid-esophageal four-chamber TEE images collected during the procedure. a TEE image after THV deployment showing normal RV size (RV Dd/Ds = 33.0/26.4 mm). b TEE image collected 2 min after protamine administration demonstrating RV dilatation (yellow arrow) (RV Dd/Ds = 37.4/34.6 mm) and left ventricular (LV Dd/Ds = 46.0/36.6 mm) volume reduction. Severe systemic hypotension was observed at the same time. c TEE image after 1 min of chest compressions (approximately 5 min after protamine administration) demonstrating that the RV and LV size and wall motion had returned to baseline (RV Dd/Ds = 30.9/25.4 mm, LV Dd/Ds = 57.2/49.4 mm). Dd dimension end-diastole, Ds dimension end-systole, LV left ventricle, RV right ventricle, TEE transesophageal echocardiography

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