My opinion

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Analogous to old-school air-tight chest tube dressing, transthoracic echocardiography probe (wireless or portable or standard) can be fixed to the chest with silk or cloth tape as demonstrated on the mannequin (Figure A). This no-cost method had been originally envisaged by our team to potentially investigate and potentially document anatomical changes in healthy volunteers’ hearts while (a) their postures change from standing to sitting to supine to lateral to prone thus validating/refuting/reproducing experts’ historical results [1-5], and/or while (b) they are riding roller coasters thus validating/refuting/reproducing experts’ historical results [6-9]. Although artificial hearts may not demonstrate changes in anatomical shapes and anatomical positions which may be potentially associated with thrills and anxieties induced by roller coaster rides’ g-forces, persons with artificial hearts may still avoid roller coaster rides altogether due to their underlying cardiac diseases. In contrast to probe silk/cloth-taped in one fixed position, ProbeFix (Usono B.V., part of Medacc Holding B.V., Eindhoven, The Netherlands) may allow easy reorientation of stabilized probe among long axis and short axis views [10-11]. However due to multi-thousand cost of ProbeFix, the cost-efficient alternative may be easily purchasable – over the counter or online – phone holder to stabilize echocardiography probe on to the immobile and supine patients’ chests for intraoperative continuous transthoracic echocardiography as demonstrated with one-version of phone holder on the mannequin (Figure B). The feasibility to reorient among long axis and short axis views may depend on the flexibility and stability of phone holder’s chosen and available version because too many versions are available over the counter and online to choose from. Essentially, stabilized holding of transthoracic echocardiography probe is mechanically possible for various clinical applications of continuous non-invasive echocardiography, intraoperatively or otherwise.

FIGURE A-B

References

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1. Shimizu M, Fujii H, Yamawake N, Nishizaki M. Cardiac function changes with switching from the supine to prone position: analysis by quantitative semiconductor gated single-photon emission computed tomography. J Nucl Cardiol. 2015;22(2):301-307. https://doi.org/10.1007/s12350-014-0058-3
2. Mita N, Kuroda M, Saito S, Miyoshi S. Effect of lateral body position on transesophageal echocardiography images and the association with patient characteristics: A prospective observational study. Ann Card Anaesth. 2015;18(3):299-305. https://doi.org/10.4103/0971-9784.159797
3. Kim H, Kim J. Evaluation of the anatomical parameters for normal tissue sparing in the prone position radiotherapy with small sized left breasts. Oncotarget. 2016;7(44):72211-72218. https://doi.org/10.18632/oncotarget.12662
4. Giustiniano E, Padua E, Negri K, Bragato RM, Cecconi M. Echocardiography during Prone-Position Mechanical Ventilation in Patients with COVID-19: A Proposal for a New Approach. J Am Soc Echocardiogr. 2020;33(7):905-906. https://doi.org/10.1016/j.echo.2020.04.027
5. García-Cruz E, Manzur-Sandoval D, Gopar-Nieto R, et al. Transthoracic echocardiography during prone position ventilation: Lessons from the COVID-19 pandemic [published online ahead of print, 2020 Aug 28]. J Am Coll Emerg Physicians Open. 2020;1(5):730-736. https://doi.org/10.1002/emp2.12239
6. Pieles GE, Husk V, Blackwell T, et al. High g-Force Rollercoaster Rides Induce Sinus Tachycardia but No Cardiac Arrhythmias in Healthy Children. Pediatr Cardiol. 2017;38(1):15-19. https://doi.org/10.1007/s00246-016-1477-5
7. Papoutsidakis N, Heitner S, Ingles J, et al. Participation in thrill-seeking activities by patients with hypertrophic cardiomyopathy: Individual preferences, adverse events and physician attitude. Am Heart J. 2019;214:28-35. https://doi.org/10.1016/j.ahj.2019.04.001
8. Carter D, Prokupetz A, Harpaz D, Barenboim E. Effects of repeated exposure to acceleration forces (+Gz) and anti-G manoeuvres on cardiac dimensions and performance. Exp Clin Cardiol. 2010;15(1):e10-e12. https://www.ncbi.nlm.nih.gov/pmc/articl es/PMC2907878/
9. Kuschyk J, Haghi D, Borggrefe M, Brade J, Wolpert C. Cardiovascular response to a modern roller coaster ride [published correction appears in JAMA. 2007 Nov 21;298(19):2264]. JAMA. 2007;298(7):739-741. https://doi.org/10.1001/jama.298.7.739-c
10. Blans MJ, Bosch FH, van der Hoeven JG. The use of an external ultrasound fixator (Probefix) on intensive care patients: a feasibility study. Ultrasound J. 2019;11(1):26. Published 2019 Oct 11. https://doi.org/10.1186/s13089-019-0140-9
11. Salden OAE, van Everdingen WM, Spee R, Doevendans PA, Cramer MJ. How I do it: feasibility of a new ultrasound probe fixator to facilitate high quality stress echocardiography. Cardiovasc Ultrasound. 2018;16(1):6. Published 2018 Mar 27. https://doi.org/10.1186/s12947-018-0124-0

 

Source(s) of Funding

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NOT APPLICABLE

Competing Interests

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NOT APPLICABLE