Neonatologist & Researcher with interest in Haemodynamics, Echocardiography, POCUS. T+RT= own. Opinion โ endorsement
London, England
Joined February 2009
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Sujith Pereira ๐ฎ๐ณ๐ฌ๐ง๐๐ด retweeted
What is systemic venous return!? It's not cvp or preload...
#physiology #cardiology #medicine #icu #criticalcare #picu #nicu #pedsicu #chd #foamed #medtwitter #pediatrics #micu
@OungSavly @alex1708ander @WithAScalpel @SIwa23288585
Sujith Pereira ๐ฎ๐ณ๐ฌ๐ง๐๐ด retweeted
PressureโVolume LoopsโDeterminants of Stroke Volume๐
๐Stroke volume (EDV โ ESV) depends on preload, contractility, and afterload; reduced ventricular compliance increases filling pressure (EDPVR).
๐Increased contractility steepens ESPVR and reduces ESV, whereas increased afterload (Ea) raises ESV and may reduce stroke volume despite higher arterial pressure.
Why does more norepinephrine sometimes make things worse? In some patients, afterload outruns contractility, ventriculo-arterial coupling falls apart, and stroke volume drops. ๐ฉ tip to the authors. eddyjoemd.com/foamed
Sujith Pereira ๐ฎ๐ณ๐ฌ๐ง๐๐ด retweeted
Extended End-to-End Anastomosis via Left Thoracotomy: Coarctation Repair
๐A left thoracotomy provides exposure of the distal arch, isthmus, and descending aorta, allowing extensive mobilization.
๐After complete resection of coarctation and ductal tissue, longitudinal incisions extend into the arch and descending aorta.
๐A wide, oblique end-to-end anastomosis restores aortic continuity and caliber while minimizing tension and residual obstruction.
Sujith Pereira ๐ฎ๐ณ๐ฌ๐ง๐๐ด retweeted
7-year-old, Laubry-Pezzi syndrome(SubpulmonicVSD-AR) @ASE360 @ACCinTouch @escardio @WGACHDChair @iamritu @CASivaram1 @jeffrey_vinocur @RobertHPass @echoleolopez @EACVIPresident @loomba_rohit @dkthekkoott @alexsfelixecho @alex1708ander @CardioNeo @sujithsp @argulian @SIwa23288585
Sujith Pereira ๐ฎ๐ณ๐ฌ๐ง๐๐ด retweeted
#POCUS, or point-of-care ultrasound, can assess the internal jugular vein to estimate #JugularVenousPressure as an approximation of right atrial pressure. Jugular venous pressure can help identify volume overload using ultrasound assessment of the neck vessels.
To assess #JugularVenousPressure with #POCUS, the patient is positioned with the head of bed elevated and the linear probe is placed above the clavicle between the bellies of the sternocleidomastoid muscle. The vertical height from the sternal angle to the point where the internal jugular vein tapers is measured to calculate jugular venous pressure.
๐ Learn more: ja.ma/47DyMYr
Sujith Pereira ๐ฎ๐ณ๐ฌ๐ง๐๐ด retweeted
facebook.com/share/p/1Bhf4Yxโฆ
๐ฉ๐ซ Coronary Artery Diagram: โจ
- Left Main Coronary Artery (LMCA)
- Left Anterior Descending (LAD) Artery
- Circumflex (Cx) Artery
- Diagonal (D1, D2) Arteries
- Obtuse Marginal (OM1, OM2) Arteries
- Septal (S1, S2) Branches.
#Cardiology
Sujith Pereira ๐ฎ๐ณ๐ฌ๐ง๐๐ด retweeted
Surgical VSD Closureโ๏ธ
Perimembranous vs conoventricular VSD on TEE ๐ทis the ๐ #echofirst @mgonzale2
Sujith Pereira ๐ฎ๐ณ๐ฌ๐ง๐๐ด retweeted
Let's gossip about contractility!!
Contractility is not stroke volume!
#icu #criticalcare #cardiology #pedsicu #pedscards #medicine #foamed #medtwitter #cicu #micu #picu #nicu #echofirst
@OungSavly @WithAScalpel @alex1708ander
Sujith Pereira ๐ฎ๐ณ๐ฌ๐ง๐๐ด retweeted
Truncus Arteriosus, type 1โ๏ธin a 4 months baby .
Sujith Pereira ๐ฎ๐ณ๐ฌ๐ง๐๐ด retweeted
Complete AVSD Repair with Two-Patch Technique: Key Anatomy and VSD Closure
๐Complete AVSD features a common AV valve, primum ASD, and inlet VSD, with superior and inferior bridging leaflets.
๐A marking stitch defines AV valve partitioning and LAVV coaptation while preserving an adequate left-sided valve orifice.
๐The displaced AV node and conduction axis lie near the inferior VSD rim; careful patch sizing and right-sided sutures are critical.
Sujith Pereira ๐ฎ๐ณ๐ฌ๐ง๐๐ด retweeted
Surgical Techniques for ALCAPA๐ค
๐Coronary reimplantation is preferred when feasible, while two-patch flap, spiral conduit, and Takeuchi techniques offer alternatives for establishing a tension-free, unobstructed two-coronary circulation.
New case report: Aortic-pulmonary conduit technique for tension-free coronary reimplantation in anomalous left coronary artery from the pulmonary artery repair. Read in #JTCVS Techniques: doi.org/10.1016/j.xjtc.2026.โฆ
See more at #Aortic2026: hubs.la/Q04Ccqkz0
Sujith Pereira ๐ฎ๐ณ๐ฌ๐ง๐๐ด retweeted
A 58-year-old man presents with progressive dyspnea.
๐น Watch the clip
What is the most likely finding?
Sujith Pereira ๐ฎ๐ณ๐ฌ๐ง๐๐ด retweeted
Ebstein AnomalyโFailure of Tricuspid Leaflet Delamination
๐Failure of tricuspid leaflet delamination causes leaflet plastering, atrialization of the RV, severe TR, and a reduced functional RV cavity.
Sujith Pereira ๐ฎ๐ณ๐ฌ๐ง๐๐ด retweeted
Pressure-Volume Loop โ Series: #1โ2
๐Pressure-volume loops illustrate ventricular mechanics through changes in preload, compliance, contractility, and afterload.
๐ESPVR and EDPVR define systolic and diastolic properties, while arterial elastance (Ea) reflects afterload.
โ Full series below
Sujith Pereira ๐ฎ๐ณ๐ฌ๐ง๐๐ด retweeted
Pressure-Volume Loop #2: Inotropy, Contractility, and Afterload
๐Increased inotropy steepens the ESPVR, reducing end-systolic volume (ESV) and increasing stroke volume and ejection fraction.
๐Reduced contractility flattens the ESPVR, increasing ESV and reducing stroke volume; compensatory dilation may increase EDV/EDP.
๐Increased afterload (โEa) raises systolic pressure and ESV, narrowing the PV loop and reducing stroke volume at a given preload.
Sujith Pereira ๐ฎ๐ณ๐ฌ๐ง๐๐ด retweeted
A sleeping ๐ด AoV๐ซ
The IntraCludeยฎ device is introduced via the femoral artery and designed to occlude the ascending aorta, isolating the aortic root from systemic arterial circulation
A valuable tool in minimally invasive cardiac surgery (MICS)
@ecsclub
@EdwardsLifesci
Sujith Pereira ๐ฎ๐ณ๐ฌ๐ง๐๐ด retweeted
Pressure-Volume Loop #1: Preload and Compliance
๐The PV loop illustrates ventricular pressure-volume changes during filling, isovolumetric contraction, ejection, and relaxation.
๐Increased preload shifts end-diastolic volume rightward, increasing stroke volume through the Frank-Starling mechanism.
๐Reduced ventricular compliance shifts the EDPVR upward, increasing filling pressure at a given end-diastolic volume.
Sujith Pereira ๐ฎ๐ณ๐ฌ๐ง๐๐ด retweeted
Rare congenital anomaly(Iโve never seen)
rudimentary aortic chordae tendineae #echofirst
seen as ruptured fibrous strand attached to RCC free edge w partial flail causing severe aortic regurgitation OR confirmed bit.ly/3ULiWIb
