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If you wish to respond to a paper or other item already published in the BJA, please go to the abstract/full text version of that item and click on the link "E-Letters: Submit a response to the article".

Electronic Letters to:

Cardiovascular:
B. van Zaane, A. P. Nierich, W. F. Buhre, G. J. Brandon Bravo Bruinsma, and K. G. M. Moons
Resolving the blind spot of transoesophageal echocardiography: a new diagnostic device for visualizing the ascending aorta in cardiac surgery
Br. J. Anaesth. 2007; 98: 434-441 [Abstract] [Full text] [PDF]
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Electronic letters published:

[Read E-letter] First use of A-view in UK
Sangram G Patil, Swansea   (22 April 2007)

First use of A-view in UK 22 April 2007
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Sangram G Patil,
SpR Anaesthetics
Morriston Hospital,
Swansea

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Re: First use of A-view in UK

Dear Sir,

This is in response to 'Resolving the blind spot of transoesophageal echocardiography: a new diagnostic device for visualizing the ascending aorta in cardiac surgery'- BJA advanced access, online, March 2, 2007.

I am very excited to report the first case of use of A-View device in UK. Patient undergoing valvular repair and CABG was consented for use of A -View, as she needed intraoperative echocardiography to guide the valve repair as well as to rule out aortic pathology (atherosclerosis). A-view device was passed under general anaesthesia before intubating the patient.

We felt the initial technical difficulty in passing this device (which is similar to bronchial blocker)in the left main bronchus. We used fiberoptic bronchoscope to guide the placement and confirmation of A-View device, though in the original study the authors have used TOE view to confirm placement and adequate balloon inflation.

TOE was performed by cardiologist before and after inflation of A- View balloon with saline. Adequate balloon inflation was confirmed with bronchoscope. A-View definitely improved the visualization of ascending aorta and helped to rule out ascending aortic atherosclerosis intra- operatively.

I think, more experience is necessary for insertion and interpretation of the A-View guided TOE. This can be one more device to keep cardiac anaesthetists busy as it can replace epiaortic ultrasound scanning (which is done by surgeons intra-operatively).

I would be more than happy to forward the TOE images before and after A-View balloon inflation if you wish so. .

Conflict of Interest:

None declared