1
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Gonzalez de Alba C, Zablah JE, Burkett D, Jone PN, Rodriguez SA, Morgan GJ. Use of Three-Dimensional Intracardiac Echocardiography Catheter in the Evaluation of Prosthetic Pulmonary Valves after Transcatheter Replacement. J Am Soc Echocardiogr 2024; 37:226-236. [PMID: 37839619 DOI: 10.1016/j.echo.2023.10.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 10/07/2023] [Accepted: 10/08/2023] [Indexed: 10/17/2023]
Abstract
Transcatheter pulmonary valve replacement (TPVR) is commonly performed in patients with congenital heart disease as a safe alternative to replacement via open heart surgery. Intracardiac echocardiography (ICE) is a useful technique for evaluating multiple structures that are difficult to assess by other echocardiographic techniques, particularly the pulmonary valve. To our knowledge, the use of three-dimensional (3D) ICE catheters to evaluate prosthetic valves after TPVR has not been reported. Three-dimensional ICE catheters offer a comprehensive evaluation of transcatheter-deployed pulmonary valves through 3D, 3D color, xPlane, and multiplane reconstruction. The aim of this study is to demonstrate the feasibility of using 3D ICE catheters, outline their role in evaluating post-TPVR deployment success and complications, consider their additive value to two-dimensional ICE, and present our institutional experience with it in 50 cases of TPVR.
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Affiliation(s)
- Cesar Gonzalez de Alba
- The Heart Institute, Children's Hospital Colorado, Aurora, Colorado; School of Medicine, Anschutz Medical Campus, University of Colorado, Aurora, Colorado.
| | - Jenny E Zablah
- The Heart Institute, Children's Hospital Colorado, Aurora, Colorado; School of Medicine, Anschutz Medical Campus, University of Colorado, Aurora, Colorado
| | - Dale Burkett
- The Heart Institute, Children's Hospital Colorado, Aurora, Colorado; School of Medicine, Anschutz Medical Campus, University of Colorado, Aurora, Colorado
| | - Pei-Ni Jone
- School of Medicine, Anschutz Medical Campus, University of Colorado, Aurora, Colorado
| | - Salvador A Rodriguez
- The Heart Institute, Children's Hospital Colorado, Aurora, Colorado; School of Medicine, Anschutz Medical Campus, University of Colorado, Aurora, Colorado
| | - Gareth J Morgan
- The Heart Institute, Children's Hospital Colorado, Aurora, Colorado; School of Medicine, Anschutz Medical Campus, University of Colorado, Aurora, Colorado; Department of Cardiology, University of Colorado Hospital, Aurora, Colorado
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2
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English CW, Rogers JH, Smith TW. Intracardiac Echocardiographic Guidance for Structural Heart Procedures: Current Utility as Compared to Transesophageal Echocardiography. Interv Cardiol Clin 2024; 13:39-49. [PMID: 37980066 DOI: 10.1016/j.iccl.2023.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2023]
Abstract
Over the past decade, engineering advances in intracardiac echocardiography (ICE) have improved the ability of an imager or interventionalist to guide not only interatrial septal procedures but now commonly left atrial appendage, tricuspid, and mitral procedures. When transesophageal echocardiography (TEE) is not possible because of anatomic limitations, ICE has proved a useful tool to safely complete structural interventions. ICE will play a growing, key role in structural interventions where anatomic factors strongly favor an intracardiac perspective or augment TEE when imaging is suboptimal.
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Affiliation(s)
- Carter W English
- Division of Cardiovascular Medicine, Department of Internal Medicine, University of California - Davis Medical Center, 4860 Y Street, Suite 2820, Sacramento, CA 95817, USA
| | - Jason H Rogers
- Division of Cardiovascular Medicine, Department of Internal Medicine, University of California - Davis Medical Center, 4860 Y Street, Suite 2820, Sacramento, CA 95817, USA
| | - Thomas W Smith
- Division of Cardiovascular Medicine, Department of Internal Medicine, University of California - Davis Medical Center, 4860 Y Street, Suite 2820, Sacramento, CA 95817, USA.
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3
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Prandi FR, Lerakis S, Belli M, Illuminato F, Margonato D, Barone L, Muscoli S, Chiocchi M, Laudazi M, Marchei M, Di Luozzo M, Kini A, Romeo F, Barillà F. Advances in Imaging for Tricuspid Transcatheter Edge-to-Edge Repair: Lessons Learned and Future Perspectives. J Clin Med 2023; 12:jcm12103384. [PMID: 37240489 DOI: 10.3390/jcm12103384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 04/20/2023] [Accepted: 05/08/2023] [Indexed: 05/28/2023] Open
Abstract
Severe tricuspid valve (TV) regurgitation (TR) has been associated with adverse long-term outcomes in several natural history studies, but isolated TV surgery presents high mortality and morbidity rates. Transcatheter tricuspid valve interventions (TTVI) therefore represent a promising field and may currently be considered in patients with severe secondary TR that have a prohibitive surgical risk. Tricuspid transcatheter edge-to-edge repair (T-TEER) represents one of the most frequently used TTVI options. Accurate imaging of the tricuspid valve (TV) apparatus is crucial for T-TEER preprocedural planning, in order to select the right candidates, and is also fundamental for intraprocedural guidance and post-procedural follow-up. Although transesophageal echocardiography represents the main imaging modality, we describe the utility and additional value of other imaging modalities such as cardiac CT and MRI, intracardiac echocardiography, fluoroscopy, and fusion imaging to assist T-TEER. Developments in the field of 3D printing, computational models, and artificial intelligence hold great promise in improving the assessment and management of patients with valvular heart disease.
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Affiliation(s)
- Francesca Romana Prandi
- Division of Cardiology, Department of Systems Medicine, Tor Vergata University, 00133 Rome, Italy
- Department of Cardiology, Mount Sinai Hospital, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Stamatios Lerakis
- Department of Cardiology, Mount Sinai Hospital, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Martina Belli
- Division of Cardiology, Department of Systems Medicine, Tor Vergata University, 00133 Rome, Italy
- Cardiovascular Imaging Unit, San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Federica Illuminato
- Division of Cardiology, Department of Systems Medicine, Tor Vergata University, 00133 Rome, Italy
| | - Davide Margonato
- Cardiovascular Imaging Unit, San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Lucy Barone
- Division of Cardiology, Department of Systems Medicine, Tor Vergata University, 00133 Rome, Italy
| | - Saverio Muscoli
- Division of Cardiology, Department of Systems Medicine, Tor Vergata University, 00133 Rome, Italy
| | - Marcello Chiocchi
- Department of Diagnostic Imaging and Interventional Radiology, Tor Vergata University, 00133 Rome, Italy
| | - Mario Laudazi
- Department of Diagnostic Imaging and Interventional Radiology, Tor Vergata University, 00133 Rome, Italy
| | - Massimo Marchei
- Division of Cardiology, Department of Systems Medicine, Tor Vergata University, 00133 Rome, Italy
| | - Marco Di Luozzo
- Division of Cardiology, Department of Systems Medicine, Tor Vergata University, 00133 Rome, Italy
| | - Annapoorna Kini
- Department of Cardiology, Mount Sinai Hospital, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Francesco Romeo
- Department of Departmental Faculty of Medicine, Unicamillus-Saint Camillus International University of Health and Medical Sciences, 00131 Rome, Italy
| | - Francesco Barillà
- Division of Cardiology, Department of Systems Medicine, Tor Vergata University, 00133 Rome, Italy
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4
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Machino-Ohtsuka T, Ishizu T, Kawakami Y. Intraoperative Imaging Strategy Unique to Japan for Transcatheter Closure of Atrial Septal Defects. Circ J 2023; 87:525-526. [PMID: 36805529 DOI: 10.1253/circj.cj-23-0045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Affiliation(s)
- Tomoko Machino-Ohtsuka
- Department of Cardiology, Faculty of Medicine, University of Tsukuba.,Department of Clinical Laboratory Medicine, Faculty of Medicine, University of Tsukuba
| | - Tomoko Ishizu
- Department of Cardiology, Faculty of Medicine, University of Tsukuba
| | - Yasushi Kawakami
- Department of Clinical Laboratory Medicine, Faculty of Medicine, University of Tsukuba
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5
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Sun F, Sun A, Chen Y, Xiao Y, Zhang X, Qiao W, Tan X, Liang Y, Li D, Yang S, Ren W. Novel TrueVue series of 3D echocardiography: Revealing the pathological morphology of congenital heart disease. Front Physiol 2022; 13:1000007. [PMID: 36148295 PMCID: PMC9485809 DOI: 10.3389/fphys.2022.1000007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 08/16/2022] [Indexed: 11/13/2022] Open
Abstract
Aims: This study explored the advantages and limitations of novel series of three-dimensional (3D) echocardiographic techniques and summarized their application methods for congenital heart diseases (CHDs). Method and result: Two-dimensional (2D), traditional 3D echocardiography, and TrueVue plus light and/or Glass novel 3D technologies were performed on 62 patients with CHD, and a clinical survey was designed to judge whether the novel 3D images were more helpful for understanding the cardiac condition and guide treatment than traditional 3D images. TrueVue increased the visual resolution and simulated the true texture of cardiac tissue, significantly improving the display ability of abnormal anatomical structures in CHDs. TrueVue Glass displayed the blood channel and the internal structure of cardiac cavity more intuitively, indicating a new observation aspect not shown by conventional echocardiography. The clinical survey results showed that the new 3D imaging methods effectively increased the diagnostic confidence of echocardiographers, enabled surgeons to better understand the details of lesions, promoted efficient communication, and improved the confidence of both doctors and patients in treatment. Conclusion: The combined application of TrueVue, TrueVue Light, and TrueVue Glass more closely simulated real anatomical features, showed more comprehensive and subtle blood flow in the lumen, not only increased the visual effect but also provided more useful diagnostic information, improved the accuracy of evaluation and treatment of CHD when compared to traditional imaging techniques, indicating that this combined application has significant clinical value.
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Affiliation(s)
- Feifei Sun
- Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang, China
| | - Aijiao Sun
- Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yixin Chen
- Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yangjie Xiao
- Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang, China
| | - Xintong Zhang
- Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang, China
| | - Wei Qiao
- Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang, China
| | - Xueying Tan
- Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yanxiao Liang
- Department of Cardiac Surgery, Shengjing Hospital of China Medical University, Shenyang, China
| | - Dongyu Li
- Department of Cardiac Surgery, Shengjing Hospital of China Medical University, Shenyang, China
| | - Shu Yang
- Department of Ultrasound, Philips Medical Technology, Shenyang, China
| | - Weidong Ren
- Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang, China
- *Correspondence: Weidong Ren,
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6
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Spanaki A, Kabir S, Stephenson N, van Poppel MPM, Benetti V, Simpson J. 3D Approaches in Complex CHD: Where Are We? Funny Printing and Beautiful Images, or a Useful Tool? J Cardiovasc Dev Dis 2022; 9:269. [PMID: 36005432 PMCID: PMC9410138 DOI: 10.3390/jcdd9080269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 08/02/2022] [Accepted: 08/05/2022] [Indexed: 11/16/2022] Open
Abstract
Echocardiography, CT and MRI have a crucial role in the management of congenital heart disease (CHD) patients. All of these modalities can be presented in a 2D or a 3D rendered format. The aim of this paper is to review the key advantages and potential limitations, as well as the future challenges of a 3D approach in each imaging modality. The focus of this review is on anatomic rather than functional assessment. Conventional 2D echocardiography presents limitations when imaging complex lesions, whereas 3D imaging depicts the anatomy in all dimensions. CT and MRI can visualise extracardiac vasculature and guide complex biventricular repair. Three-dimensional printed models can be used in depicting complex intracardiac relationships and defining the surgical strategy in specific lesions. Extended reality imaging retained dynamic cardiac motion holds great potential for planning surgical and catheter procedures. Overall, the use of 3D imaging has resulted in a better understanding of anatomy, with a direct impact on the surgical and catheter approach, particularly in more complex cases.
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Affiliation(s)
- Adriani Spanaki
- Department of Congenital Heart Disease, Evelina London Children’s Hospital, Guy’s and St Thomas NHS Foundation Trust, London SE1 7EH, UK
| | - Saleha Kabir
- Department of Congenital Heart Disease, Evelina London Children’s Hospital, Guy’s and St Thomas NHS Foundation Trust, London SE1 7EH, UK
| | - Natasha Stephenson
- School of Biomedical Engineering & Imaging Sciences, King’s College London, King’s Health Partners, St Thomas’ Hospital, London SE1 7EH, UK
| | - Milou P. M. van Poppel
- School of Biomedical Engineering & Imaging Sciences, King’s College London, King’s Health Partners, St Thomas’ Hospital, London SE1 7EH, UK
| | - Valentina Benetti
- Department of Congenital Heart Disease, Evelina London Children’s Hospital, Guy’s and St Thomas NHS Foundation Trust, London SE1 7EH, UK
| | - John Simpson
- Department of Congenital Heart Disease, Evelina London Children’s Hospital, Guy’s and St Thomas NHS Foundation Trust, London SE1 7EH, UK
- School of Biomedical Engineering & Imaging Sciences, King’s College London, King’s Health Partners, St Thomas’ Hospital, London SE1 7EH, UK
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7
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Avesani M, Kang SL, Jalal Z, Thambo JB, Iriart X. Renaissance of Cardiac Imaging to Assist Percutaneous Interventions in Congenital Heart Diseases:The Role of Three-Dimensional Echocardiography and Multimodality Imaging. Front Pediatr 2022; 10:894472. [PMID: 35664875 PMCID: PMC9160663 DOI: 10.3389/fped.2022.894472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 04/12/2022] [Indexed: 11/20/2022] Open
Abstract
Percutaneous interventions have completely refashioned the management of children with congenital heart diseases (CHD) and the use of non-invasive imaging has become the gold standard to plan and guide these procedures in the modern era. We are now facing a dual challenge to improve the standard of care in low-risk patients, and to shift our strategies from the classic open chest surgery to imaging-guided percutaneous interventions in high-risk patients. Such rapid evolution of ultrasound technologies over the last 20 years have permitted the integration of transthoracic, transesophageal and intracardiac echocardiography into the interventional workflow to improve image guidance and reduce radiation burden from fluoroscopy and angiography. Specifically, miniaturization of transesophageal probe and advances in three-dimensional (3D) imaging techniques have enabled real-time 3D image guidance during complex interventional procedure, In addition, multimodality and fusion imaging techniques harness the strengths of different modalities to enhance understanding of anatomical and spatial relationship between different structures, improving communication and coordination between interventionalists and imaging specialists. In this review, we aim to provide an overview of 3D imaging modalities and multimodal fusion in procedural planning and live guidance of percutaneous interventions. At the present times, 3D imaging can no longer be considered a luxury but a routine clinical tool to improve procedural success and patient outcomes.
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Affiliation(s)
- Martina Avesani
- Department of Pediatric and Congenital Cardiology, M3C National Reference Centre, Bordeaux University Hospital, Bordeaux, France
| | - Sok-Leng Kang
- Department of Pediatric Cardiology, Alder Hey Children's Hospital, Liverpool, United Kingdom
| | - Zakaria Jalal
- Department of Pediatric and Congenital Cardiology, M3C National Reference Centre, Bordeaux University Hospital, Bordeaux, France.,Institut Hospitalo-Universitaire (IHU) Liryc, Electrophysiology and Heart Modeling Institute, Bordeaux University Foundation, Pessac, France
| | - Jean-Benoit Thambo
- Department of Pediatric and Congenital Cardiology, M3C National Reference Centre, Bordeaux University Hospital, Bordeaux, France.,Institut Hospitalo-Universitaire (IHU) Liryc, Electrophysiology and Heart Modeling Institute, Bordeaux University Foundation, Pessac, France
| | - Xavier Iriart
- Department of Pediatric and Congenital Cardiology, M3C National Reference Centre, Bordeaux University Hospital, Bordeaux, France.,Institut Hospitalo-Universitaire (IHU) Liryc, Electrophysiology and Heart Modeling Institute, Bordeaux University Foundation, Pessac, France
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8
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Hagemeyer D, Ali FM, Ong G, Fam NP. The Role of Intracardiac Echocardiography in Percutaneous Tricuspid Intervention: A New ICE Age. Interv Cardiol Clin 2021; 11:103-112. [PMID: 34838293 DOI: 10.1016/j.iccl.2021.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The prevalence of severe tricuspid regurgitation in older patients is high, and the clinical relevance is perceived more and more in recent years. Many of these patients are not suitable for surgery because of their age and comorbidities. Therefore, a variety of percutaneous interventions have been developed to address this unmet need. Procedural success strongly depends on adequate imaging during the intervention. Although transesophageal echocardiography is the standard of care, imaging may be limited due to anatomic factors and adverse acoustic shadowing. In this review, we discuss the current and future role of intracardiac echocardiography in tricuspid valve interventions.
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Affiliation(s)
- Daniel Hagemeyer
- Division of Cardiology, St. Michael's Hospital, 30 Bond Street, Toronto, Ontario M5B 1W8, Canada. https://twitter.com/DanielHagemeyer
| | - Faeez M Ali
- Division of Cardiology, St. Michael's Hospital, 30 Bond Street, Toronto, Ontario M5B 1W8, Canada; Waikato Hospital, 183 Pembroke Street, Hamilton 3204, New Zealand
| | - Geraldine Ong
- Division of Cardiology, St. Michael's Hospital, 30 Bond Street, Toronto, Ontario M5B 1W8, Canada
| | - Neil P Fam
- Division of Cardiology, St. Michael's Hospital, 30 Bond Street, Toronto, Ontario M5B 1W8, Canada.
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9
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HAN KN, MA XT, YANG SW, ZHOU YJ. Intracardiac echocardiography in the diagnosis and closure of patent foramen ovale. J Geriatr Cardiol 2021; 18:697-701. [PMID: 34659375 PMCID: PMC8501384 DOI: 10.11909/j.issn.1671-5411.2021.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Affiliation(s)
- Kang-Ning HAN
- Beijing Anzhen Hospital, Capital Medical University; Beijing Institute of Heart, Lung and Blood Vessel Disease; The Key Laboratory of Remodeling-related Cardiovascular Disease, Ministry of Education; Beijing, China
| | - Xiao-Teng MA
- Beijing Anzhen Hospital, Capital Medical University; Beijing Institute of Heart, Lung and Blood Vessel Disease; The Key Laboratory of Remodeling-related Cardiovascular Disease, Ministry of Education; Beijing, China
| | - Shi-Wei YANG
- Beijing Anzhen Hospital, Capital Medical University; Beijing Institute of Heart, Lung and Blood Vessel Disease; The Key Laboratory of Remodeling-related Cardiovascular Disease, Ministry of Education; Beijing, China
| | - Yu-Jie ZHOU
- Beijing Anzhen Hospital, Capital Medical University; Beijing Institute of Heart, Lung and Blood Vessel Disease; The Key Laboratory of Remodeling-related Cardiovascular Disease, Ministry of Education; Beijing, China
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10
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Gianni C, Della Rocca DG, Horton RP, Burkhardt JD, Natale A, Al-Ahmad A. Real-Time 3D Intracardiac Echocardiography. Card Electrophysiol Clin 2021; 13:419-426. [PMID: 33990280 DOI: 10.1016/j.ccep.2021.03.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
With real-time three-dimensional ultrasound, live volumetric images with adequate spatial and temporal resolution are obtained to accurately display structures with complex anatomy and guide interventional procedures. In this review, we will provide an overview of current ultrasound technologies that allow for real-time three-dimensional imaging, with a focus on their application for three-dimensional intracardiac echocardiography.
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Affiliation(s)
- Carola Gianni
- Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, TX, USA.
| | | | - Rodney P Horton
- Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, TX, USA
| | - J David Burkhardt
- Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, TX, USA
| | - Andrea Natale
- Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, TX, USA; HCA National Medical Director of Cardiac Electrophysiology, Nashville, TN, USA; Interventional Electrophysiology, Scripps Clinic, La Jolla, CA, USA; MetroHealth Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Amin Al-Ahmad
- Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, TX, USA
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11
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Qian PC, Tedrow UB. Intracardiac Echocardiography to Guide Catheter Ablation of Ventricular Arrhythmias in Ischemic Cardiomyopathy. Card Electrophysiol Clin 2021; 13:285-292. [PMID: 33990267 DOI: 10.1016/j.ccep.2021.02.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Intracardiac echocardiography (ICE) allows intraprocedural assessment of cardiac anatomy and identification of ischemic myocardial scar and is useful for guidance of the ablation catheter and monitoring for complications. In this review, the authors discuss and provide examples of how ICE can be used to obtain additional information to understand arrhythmia mechanisms and facilitate catheter ablation therapy for ventricular arrhythmias arising from ischemic scar substrates.
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Affiliation(s)
- Pierre C Qian
- Department of Cardiology, Westmead Hospital, Sydney, Australia
| | - Usha B Tedrow
- Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA.
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12
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Kim YJ, Wolf PD. 3-D Ultrasound Imaging Using Helicoid Array Transducers. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2021; 68:697-706. [PMID: 32894714 DOI: 10.1109/tuffc.2020.3022616] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Real-time 3-D intracardiac echocardiography (ICE) can enable faster imaging of surfaces orthogonal to the transducer, such as the pulmonary vein (PV) antra and cardiac valve annuli. However, the requirement for a 2-D grid of individually wired elements makes a traditional matrix array challenging to implement within an intravenous catheter. Helicoid array transducers are linear array transducers twisted about their long axis, allowing imaging of different elevation slices using sub-apertures. In this work, we examined the 3-D imaging characteristics of helicoid array transducers through simulations using Field II software and experimental measurements. We report results for varying transducer parameters, such as twist rate and sub-aperture size. We also discuss design considerations for these imaging parameters as they pertain to volumetric imaging of the heart.
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13
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Assessment and procedural guidance with echocardiography for transcatheter tricuspid regurgitation devices. Prog Cardiovasc Dis 2019; 62:452-458. [DOI: 10.1016/j.pcad.2019.09.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 09/18/2019] [Indexed: 11/18/2022]
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14
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Faza NN, Özden Tok Ö, Hahn RT. Imaging in Structural Heart Disease: The Evolution of a New Subspecialty. JACC Case Rep 2019; 1:440-445. [PMID: 34316851 PMCID: PMC8288782 DOI: 10.1016/j.jaccas.2019.08.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Accepted: 08/29/2019] [Indexed: 06/06/2023]
Abstract
Structural heart disease is a new field in cardiovascular medicine, which has resulted in the creation of a new imaging subspecialty. Structural heart disease imagers have been instrumental in stimulating innovations in both the imaging and interventional spheres. Perhaps most importantly, they play a key role on the clinical heart team, interacting with team members and patients before, during, and long after a structural procedure is performed.
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Affiliation(s)
- Nadeen N. Faza
- Houston Methodist DeBakey Heart and Vascular Center, Houston Methodist Hospital, Houston, Texas
| | - Özge Özden Tok
- Cardiology Department, Memorial Bahçelievler Hospital, Istanbul, Turkey
| | - Rebecca T. Hahn
- Columbia University Medical Center/NewYork–Presbyterian Hospital, New York, New York
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15
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Enriquez A, Saenz LC, Rosso R, Silvestry FE, Callans D, Marchlinski FE, Garcia F. Use of Intracardiac Echocardiography in Interventional Cardiology: Working With the Anatomy Rather Than Fighting It. Circulation 2019; 137:2278-2294. [PMID: 29784681 DOI: 10.1161/circulationaha.117.031343] [Citation(s) in RCA: 143] [Impact Index Per Article: 28.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The indications for catheter-based structural and electrophysiological procedures have recently expanded to more complex scenarios, in which an accurate definition of the variable individual cardiac anatomy is key to obtain optimal results. Intracardiac echocardiography (ICE) is a unique imaging modality able to provide high-resolution real-time visualization of cardiac structures, continuous monitoring of catheter location within the heart, and early recognition of procedural complications, such as pericardial effusion or thrombus formation. Additional benefits are excellent patient tolerance, reduction of fluoroscopy time, and lack of need for general anesthesia or a second operator. For these reasons, ICE has largely replaced transesophageal echocardiography as ideal imaging modality for guiding certain procedures, such as atrial septal defect closure and catheter ablation of cardiac arrhythmias, and has an emerging role in others, including mitral valvuloplasty, transcatheter aortic valve replacement, and left atrial appendage closure. In electrophysiology procedures, ICE allows integration of real-time images with electroanatomic maps; it has a role in assessment of arrhythmogenic substrate, and it is particularly useful for mapping structures that are not visualized by fluoroscopy, such as the interatrial or interventricular septum, papillary muscles, and intracavitary muscular ridges. Most recently, a three-dimensional (3D) volumetric ICE system has also been developed, with potential for greater anatomic information and a promising role in structural interventions. In this state-of-the-art review, we provide guidance on how to conduct a comprehensive ICE survey and summarize the main applications of ICE in a variety of structural and electrophysiology procedures.
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Affiliation(s)
- Andres Enriquez
- Section of Cardiac Electrophysiology (A.E., D.C., F.E.M., F.G.)
| | - Luis C Saenz
- Cardiovascular Division, Hospital of the University of Pennsylvania, Philadelphia. Instituto de Cardiologia. Centro Internacional de Arritmias "Andrea Natale," Fundacion Cardioinfantil, Bogota, Colombia (L.C.S.)
| | - Raphael Rosso
- Cardiac Eletrophysiology, Cardiology Division, Tel-Aviv Souraski Medical Center, Israel (R.R.)
| | | | - David Callans
- Section of Cardiac Electrophysiology (A.E., D.C., F.E.M., F.G.)
| | | | - Fermin Garcia
- Section of Cardiac Electrophysiology (A.E., D.C., F.E.M., F.G.)
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16
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Boudoulas KD, Marmagkiolis K, Boudoulas H. Atrial Septal Defect Sizing and Transcatheter Closure. Cardiology 2019; 142:105-108. [PMID: 31117079 DOI: 10.1159/000496348] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2018] [Accepted: 12/04/2018] [Indexed: 11/19/2022]
Affiliation(s)
- Konstantinos Dean Boudoulas
- Division of Cardiovascular Medicine, Department of Medicine, The Ohio State University, Columbus, Ohio, USA,
| | | | - Harisios Boudoulas
- Division of Cardiovascular Medicine, Department of Medicine, The Ohio State University, Columbus, Ohio, USA.,Biomedical Research Foundation, Academy of Athens, Athens, Greece
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Puchalski MD, Lui GK, Miller-Hance WC, Brook MM, Young LT, Bhat A, Roberson DA, Mercer-Rosa L, Miller OI, Parra DA, Burch T, Carron HD, Wong PC. Guidelines for Performing a Comprehensive Transesophageal Echocardiographic. J Am Soc Echocardiogr 2019; 32:173-215. [DOI: 10.1016/j.echo.2018.08.016] [Citation(s) in RCA: 76] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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18
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Intracardiac Echocardiography in Structural Heart Disease Interventions. JACC Cardiovasc Interv 2018; 11:2133-2147. [DOI: 10.1016/j.jcin.2018.06.056] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Revised: 05/17/2018] [Accepted: 06/05/2018] [Indexed: 01/17/2023]
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19
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Enriquez A, Garcia F. Ventricular Arrhythmias From the Infundibular Muscles: Another Step in Understanding the Complex Right Ventricular Anatomy. Circ Arrhythm Electrophysiol 2018; 11:e006248. [PMID: 29874172 DOI: 10.1161/circep.118.006248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Andres Enriquez
- From the Section of Cardiac Electrophysiology, Hospital of the University of Pennsylvania, Philadelphia (A.E., F.G.); and Arrhythmia Service, Hospital Guillermo Grant Benavente, Concepcion, Chile (A.E.)
| | - Fermin Garcia
- From the Section of Cardiac Electrophysiology, Hospital of the University of Pennsylvania, Philadelphia (A.E., F.G.); and Arrhythmia Service, Hospital Guillermo Grant Benavente, Concepcion, Chile (A.E.).
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Role of Echocardiography in Transcatheter Mitral Valve Replacement in Native Mitral Valves and Mitral Rings. J Am Soc Echocardiogr 2018; 31:475-490. [DOI: 10.1016/j.echo.2018.01.011] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Indexed: 02/06/2023]
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21
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Suntharos P, Setser RM, Bradley-Skelton S, Prieto LR. Real-time three dimensional CT and MRI to guide interventions for congenital heart disease and acquired pulmonary vein stenosis. Int J Cardiovasc Imaging 2017; 33:1619-1626. [PMID: 28455631 DOI: 10.1007/s10554-017-1151-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Accepted: 04/25/2017] [Indexed: 11/28/2022]
Abstract
To validate the feasibility and spatial accuracy of pre-procedural 3D images to 3D rotational fluoroscopy registration to guide interventional procedures in patients with congenital heart disease and acquired pulmonary vein stenosis. Cardiac interventions in patients with congenital and structural heart disease require complex catheter manipulation. Current technology allows registration of the anatomy obtained from 3D CT and/or MRI to be overlaid onto fluoroscopy. Thirty patients scheduled for interventional procedures from 12/2012 to 8/2015 were prospectively recruited. A C-arm CT using a biplane C-arm system (Artis zee, VC14H, Siemens Healthcare) was acquired to enable 3D3D registration with pre-procedural images. Following successful image fusion, the anatomic landmarks marked in pre-procedural images were overlaid on live fluoroscopy. The accuracy of image registration was determined by measuring the distance between overlay markers and a reference point in the image. The clinical utility of the registration was evaluated as either "High", "Medium" or "None". Seventeen patients with congenital heart disease and 13 with acquired pulmonary vein stenosis were enrolled. Accuracy and benefit of registration were not evaluated in two patients due to suboptimal images. The distance between the marker and the actual anatomical location was 0-2 mm in 18 (64%), 2-4 mm in 3 (11%) and >4 mm in 7 (25%) patients. 3D3D registration was highly beneficial in 18 (64%), intermediate in 3 (11%), and not beneficial in 7 (25%) patients. 3D3D registration can facilitate complex congenital and structural interventions. It may reduce procedure time, radiation and contrast dose.
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Affiliation(s)
- Patcharapong Suntharos
- Department of Pediatric Cardiology, Cleveland Clinic Children's, 9500 Euclid Avenue, Desk M-41, Cleveland, OH, 44195, USA.
| | | | - Sharon Bradley-Skelton
- Department of Pediatric Cardiology, Cleveland Clinic Children's, 9500 Euclid Avenue, Desk M-41, Cleveland, OH, 44195, USA
| | - Lourdes R Prieto
- Department of Pediatric Cardiology, Cleveland Clinic Children's, 9500 Euclid Avenue, Desk M-41, Cleveland, OH, 44195, USA
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22
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Alqahtani F, Bhirud A, Aljohani S, Mills J, Kawsara A, Runkana A, Alkhouli M. Intracardiac versus transesophageal echocardiography to guide transcatheter closure of interatrial communications: Nationwide trend and comparative analysis. J Interv Cardiol 2017; 30:234-241. [PMID: 28439973 DOI: 10.1111/joic.12382] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Revised: 03/25/2017] [Accepted: 03/29/2017] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVES This study aimed to assess current temporal trends in utilization of ICE versus TEE guided closure of interatrial communications, and to compare periprocedural complications and resource utilization between the two imaging modalities. BACKGROUND While transesophageal echocardiography (TEE) has historically been used to guide percutaneous structural heart interventions, intracardiac echocardiography (ICE) is being increasingly utilized to guide many of these procedures such as closure of interatrial communications. METHODS Using the Nationwide Inpatient Sample, all patients aged >18 years, who underwent ASD or PFO closure with either ICE or TEE guidance between 2003 and 2014 were included. Comparative analysis of outcomes and resource utilization was performed using a propensity score-matching model. RESULTS ICE guidance for interatrial communication closure increased from 9.7% in 2003 to 50.6% in 2014. In the matched model, the primary endpoint of major adverse cardiovascular events occurred less frequently in the ICE group versus the TEE group (11.1% vs 14.3%, respectively, P = 0.008), mainly driven by less vascular complications in the ICE group (0.5% vs 1.3%, P = 0.045). Length of stay was shorter in the ICE group (3 ± 4 vs 4 ± 4 days, P < 0.0001). Cost was similar in the two groups 18 454 ± 17 035$ in the TEE group vs 18 278 ± 15 780$ in the ICE group (P = 0.75). CONCLUSIONS Intracardiac echocardiogram utilization to guide closure of interatrial communications has plateaued after a rapid rise throughout the 2000s. When utilized to guide interatrial communication closure procedure, ICE is as safe as TEE and does not increase cost or prolonged hospitalizations.
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Affiliation(s)
- Fahad Alqahtani
- Division of Cardiovascular Disease, West Virginia University, Morgantown, West Virginia
| | - Ashwin Bhirud
- Division of Cardiovascular Disease, West Virginia University, Morgantown, West Virginia
| | - Sami Aljohani
- Division of Cardiovascular Disease, West Virginia University, Morgantown, West Virginia
| | - James Mills
- Division of Cardiovascular Disease, West Virginia University, Morgantown, West Virginia
| | - Akram Kawsara
- Division of Cardiovascular Disease, West Virginia University, Morgantown, West Virginia
| | - Ashok Runkana
- Division of Cardiovascular Disease, West Virginia University, Morgantown, West Virginia
| | - Mohamad Alkhouli
- Division of Cardiovascular Disease, West Virginia University, Morgantown, West Virginia
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Sharen GW, Zhang J, Qin C, Lv Q. Dynamic characteristic mechanism of atrial septal defect using real-time three-dimensional echocardiography and evaluation of right ventricular functions. JOURNAL OF HUAZHONG UNIVERSITY OF SCIENCE AND TECHNOLOGY. MEDICAL SCIENCES = HUA ZHONG KE JI DA XUE XUE BAO. YI XUE YING DE WEN BAN = HUAZHONG KEJI DAXUE XUEBAO. YIXUE YINGDEWEN BAN 2017; 37:140-147. [PMID: 28224424 DOI: 10.1007/s11596-017-1707-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Revised: 12/22/2016] [Indexed: 06/06/2023]
Abstract
The dynamic characteristics of the area of the atrial septal defect (ASD) were evaluated using the technique of real-time three-dimensional echocardiography (RT 3DE), the potential factors responsible for the dynamic characteristics of the area of ASD were observed, and the overall and local volume and functions of the patients with ASD were measured. RT 3DE was performed on the 27 normal controls and 28 patients with ASD. Based on the three-dimensional data workstations, the area of ASD was measured at P wave vertex, R wave vertex, T wave starting point, and T wave terminal point and in the T-P section. The right atrial volume in the same time phase of the cardiac cycle and the motion displacement distance of the tricuspid annulus in the corresponding period were measured. The measured value of the area of ASD was analyzed. The changes in the right atrial volume and the motion displacement distance of the tricuspid annulus in the normal control group and the ASD group were compared. The right ventricular ejection fractions in the normal control group and the ASD group were compared using the RT 3DE long-axis eight-plane (LA 8-plane) method. Real-time three-dimensional volume imaging was performed in the normal control group and ASD group (n=30). The right ventricular inflow tract, outflow tract, cardiac apex muscular trabecula dilatation, end-systolic volume, overall dilatation, end-systolic volume, and appropriate local and overall ejection fractions in both two groups were measured with the four-dimensional right ventricular quantitative analysis method (4D RVQ) and compared. The overall right ventricular volume and the ejection fraction measured by the LA 8-plane method and 4D RVQ were subjected to a related analysis. Dynamic changes occurred to the area of ASD in the cardiac cycle. The rules for dynamic changes in the area of ASD and the rules for changes in the right atrial volume in the cardiac cycle were consistent. The maximum value of the changes in the right atrial volume occurred in the end-systolic period when the peak of the curve appeared. The minimum value of the changes occurred in the end-systolic period and was located at the lowest point of the volume variation curve. The area variation curve for ASD and the motion variation curve for the tricuspid annulus in the cardiac cycle were the same. The displacement of the tricuspid annulus exhibited directionality. The measured values of the area of ASD at P wave vertex, R wave vertex, T wave starting point, T wave terminal point and in the T-P section were properly correlated with the right atrial volume (P<0.001). The area of ASD and the motion displacement distance of the tricuspid annulus were negatively correlated (P<0.05). The right atrial volumes in the ASD group in the cardiac cycle in various time phases increased significantly as compared with those in the normal control group (P=0.0001). The motion displacement distance of the tricuspid annulus decreased significantly in the ASD group as compared with that in the normal control group (P=0.043). The right ventricular ejection fraction in the ASD group was lower than that in the normal control group (P=0.032). The ejection fraction of the cardiac apex trabecula of the ASD patients was significantly lower than the ejection fractions of the right ventricular outflow tract and inflow tract and overall ejection fraction. The difference was statistically significant (P=0.005). The right ventricular local and overall dilatation and end-systolic volumes in the ASD group increased significantly as compared with those in the normal control group (P=0.031). The aRVEF and the overall ejection fraction decreased in the ASD group as compared with those in the normal control group (P=0.0005). The dynamic changes in the area of ASD and the motion curves for the right atrial volume and tricuspid annulus have the same dynamic characteristics. RT 3DE can be used to accurately evaluate the local and overall volume and functions of the right ventricle. The local and overall volume loads of the right ventricle in the ASD patients increase significantly as compared with those of the normal people. The right ventricular cardiac apex and the overall systolic function decrease.
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Affiliation(s)
- Gao-Wa Sharen
- Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, China
- Department of Ultrasound, Affiliated Hospital of Inner Mongolia Medical University, Huhhot, 010059, China
| | - Jun Zhang
- Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, China
- Department of Urology, Affiliated Hospital of Inner Mongolia Medical University, Huhhot, 010059, China
| | - Chuan Qin
- Department of Ultrasound, Central Hospital of Karamay, Karamay, 834000, China
| | - Qing Lv
- Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, China.
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24
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Wildes D, Lee W, Haider B, Cogan S, Sundaresan K, Mills DM, Yetter C, Hart PH, Haun CR, Concepcion M, Kirkhorn J, Bitoun M. 4-D ICE: A 2-D Array Transducer With Integrated ASIC in a 10-Fr Catheter for Real-Time 3-D Intracardiac Echocardiography. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2016; 63:2159-2173. [PMID: 27740477 DOI: 10.1109/tuffc.2016.2615602] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
We developed a 2.5 ×6.6 mm 2 2 -D array transducer with integrated transmit/receive application-specific integrated circuit (ASIC) for real-time 3-D intracardiac echocardiography (4-D ICE) applications. The ASIC and transducer design were optimized so that the high-voltage transmit, low-voltage time-gain control and preamp, subaperture beamformer, and digital control circuits for each transducer element all fit within the 0.019-mm 2 area of the element. The transducer assembly was deployed in a 10-Fr (3.3-mm diameter) catheter, integrated with a GE Vivid E9 ultrasound imaging system, and evaluated in three preclinical studies. The 2-D image quality and imaging modes were comparable to commercial 2-D ICE catheters. The 4-D field of view was at least 90 ° ×60 ° ×8 cm and could be imaged at 30 vol/s, sufficient to visualize cardiac anatomy and other diagnostic and therapy catheters. 4-D ICE should significantly reduce X-ray fluoroscopy use and dose during electrophysiology ablation procedures. 4-D ICE may be able to replace transesophageal echocardiography (TEE), and the associated risks and costs of general anesthesia, for guidance of some structural heart procedures.
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25
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Simpson J, Lopez L, Acar P, Friedberg MK, Khoo NS, Ko HH, Marek J, Marx G, McGhie JS, Meijboom F, Roberson D, Van den Bosch A, Miller O, Shirali G. Three-dimensional Echocardiography in Congenital Heart Disease: An Expert Consensus Document from the European Association of Cardiovascular Imaging and the American Society of Echocardiography. J Am Soc Echocardiogr 2016; 30:1-27. [PMID: 27838227 DOI: 10.1016/j.echo.2016.08.022] [Citation(s) in RCA: 71] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Three-dimensional echocardiography (3DE) has become important in the management of patients with congenital heart disease (CHD), particularly with pre-surgical planning, guidance of catheter intervention, and functional assessment of the heart. 3DE is increasingly used in children because of good acoustic windows and the non-invasive nature of the technique. The aim of this paper is to provide a review of the optimal application of 3DE in CHD including technical considerations, image orientation, application to different lesions, procedural guidance, and functional assessment.
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Affiliation(s)
- John Simpson
- Evelina London Children's Hospital, London, United Kingdom.
| | - Leo Lopez
- Nicklaus Children's Hospital, Miami, Florida
| | | | | | - Nee S Khoo
- Stollery Children's Hospital & University of Alberta, Edmonton, Alberta, Canada
| | - H Helen Ko
- Mt. Sinai Medical Center, New York, New York
| | - Jan Marek
- Great Ormond Street Hospital for Children, London, United Kingdom
| | - Gerald Marx
- Boston Children's Hospital and Harvard School of Medicine, Boston, Massachusetts
| | - Jackie S McGhie
- Erasmus University Medical Center, Rotterdam, The Netherlands
| | | | - David Roberson
- Advocate Children's Hospital, Chicago Medical School, Chicago, Illinois
| | | | - Owen Miller
- Evelina London Children's Hospital, London, United Kingdom
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26
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Simpson J, Lopez L, Acar P, Friedberg M, Khoo N, Ko H, Marek J, Marx G, McGhie J, Meijboom F, Roberson D, Van den Bosch A, Miller O, Shirali G. Three-dimensional echocardiography in congenital heart disease: an expert consensus document from the European Association of Cardiovascular Imaging and the American Society of Echocardiography. Eur Heart J Cardiovasc Imaging 2016; 17:1071-97. [DOI: 10.1093/ehjci/jew172] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Accepted: 06/28/2016] [Indexed: 01/02/2023] Open
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27
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Rodríguez Fernández A, Bethencourt González A. Técnicas de imagen en el intervencionismo percutáneo estructural: cierre de comunicación interauricular y oclusión de la orejuela izquierda. Rev Esp Cardiol 2016. [DOI: 10.1016/j.recesp.2016.04.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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28
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Rodríguez Fernández A, Bethencourt González A. Imaging Techniques in Percutaneous Cardiac Structural Interventions: Atrial Septal Defect Closure and Left Atrial Appendage Occlusion. ACTA ACUST UNITED AC 2016; 69:766-77. [PMID: 27354151 DOI: 10.1016/j.rec.2016.04.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Accepted: 04/06/2016] [Indexed: 11/19/2022]
Abstract
Because of advances in cardiac structural interventional procedures, imaging techniques are playing an increasingly important role. Imaging studies show sufficient anatomic detail of the heart structure to achieve an excellent outcome in interventional procedures. Up to 98% of atrial septal defects at the ostium secundum can be closed successfully with a percutaneous procedure. Candidates for this type of procedure can be identified through a systematic assessment of atrial septum anatomy, locating and measuring the size and shape of all defects, their rims, and the degree and direction of shunting. Three dimensional echocardiography has significantly improved anatomic assessments and the end result itself. In the future, when combined with other imaging techniques such as cardiac computed tomography and fluoroscopy, 3-dimensional echocardiography will be particularly useful for procedure guidance. Percutaneous closure of the left atrial appendage offers an alternative for treating patients with atrial fibrillation and contraindication for oral anticoagulants. In the future, the clinical focus may well turn to stroke prevention in selected patients. Percutaneous closure is effective and safe; device implantation is successful in 94% to 99% of procedures. However, the procedure requires an experienced cardiac structural interventional team. At present, 3-dimensional echocardiography is the most appropriate imaging technique to assess anatomy suitability, select device type and size, guide the procedure alongside fluoroscopy, and to follow-up the patient afterwards.
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29
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Silvestry FE, Cohen MS, Armsby LB, Burkule NJ, Fleishman CE, Hijazi ZM, Lang RM, Rome JJ, Wang Y. Guidelines for the Echocardiographic Assessment of Atrial Septal Defect and Patent Foramen Ovale: From the American Society of Echocardiography and Society for Cardiac Angiography and Interventions. J Am Soc Echocardiogr 2016; 28:910-58. [PMID: 26239900 DOI: 10.1016/j.echo.2015.05.015] [Citation(s) in RCA: 298] [Impact Index Per Article: 37.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Frank E Silvestry
- Hospital of the University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Meryl S Cohen
- Children's Hospital of Philadelphia, Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Laurie B Armsby
- Doernbecher Children's Hospital, Oregon Health and Sciences University, Portland, Oregon
| | | | - Craig E Fleishman
- Arnold Palmer Hospital for Children, University of Central Florida College of Medicine, Orlando, Florida
| | | | - Roberto M Lang
- University of Chicago Hospital, University of Chicago School of Medicine, Chicago, Illinois
| | - Jonathan J Rome
- Children's Hospital of Philadelphia, Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Yan Wang
- Children's Hospital of Philadelphia, Perelman School of Medicine, Philadelphia, Pennsylvania
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30
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Natarajan N, Patel P, Bartel T, Kapadia S, Navia J, Stewart W, Tuzcu EM, Schoenhagen P. Peri-procedural imaging for transcatheter mitral valve replacement. Cardiovasc Diagn Ther 2016; 6:144-59. [PMID: 27054104 DOI: 10.21037/cdt.2016.02.04] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Mitral regurgitation (MR) has a high prevalence in older patient populations of industrialized nations. Common etiologies are structural, degenerative MR and functional MR secondary to myocardial remodeling. Because of co-morbidities and associated high surgical risk, open surgical mitral repair/replacement is deferred in a significant percentage of patients. For these patients transcatheter repair/replacement are emerging as treatment options. Because of the lack of direct visualization, pre- and intra-procedural imaging is critical for these procedures. In this review, we summarize mitral valve anatomy, trans-catheter mitral valve replacement (TMVR) options, and imaging in the context of TMVR.
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Affiliation(s)
- Navin Natarajan
- 1 Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA ; 2 Department of Cardiovascular Medicine, 3 Department of Cardiothoracic Surgery, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH 44106, USA ; 4 Imaging Institute, Cleveland Clinic, Cleveland, OH 44106, USA
| | - Parag Patel
- 1 Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA ; 2 Department of Cardiovascular Medicine, 3 Department of Cardiothoracic Surgery, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH 44106, USA ; 4 Imaging Institute, Cleveland Clinic, Cleveland, OH 44106, USA
| | - Thomas Bartel
- 1 Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA ; 2 Department of Cardiovascular Medicine, 3 Department of Cardiothoracic Surgery, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH 44106, USA ; 4 Imaging Institute, Cleveland Clinic, Cleveland, OH 44106, USA
| | - Samir Kapadia
- 1 Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA ; 2 Department of Cardiovascular Medicine, 3 Department of Cardiothoracic Surgery, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH 44106, USA ; 4 Imaging Institute, Cleveland Clinic, Cleveland, OH 44106, USA
| | - Jose Navia
- 1 Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA ; 2 Department of Cardiovascular Medicine, 3 Department of Cardiothoracic Surgery, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH 44106, USA ; 4 Imaging Institute, Cleveland Clinic, Cleveland, OH 44106, USA
| | - William Stewart
- 1 Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA ; 2 Department of Cardiovascular Medicine, 3 Department of Cardiothoracic Surgery, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH 44106, USA ; 4 Imaging Institute, Cleveland Clinic, Cleveland, OH 44106, USA
| | - E Murat Tuzcu
- 1 Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA ; 2 Department of Cardiovascular Medicine, 3 Department of Cardiothoracic Surgery, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH 44106, USA ; 4 Imaging Institute, Cleveland Clinic, Cleveland, OH 44106, USA
| | - Paul Schoenhagen
- 1 Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA ; 2 Department of Cardiovascular Medicine, 3 Department of Cardiothoracic Surgery, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH 44106, USA ; 4 Imaging Institute, Cleveland Clinic, Cleveland, OH 44106, USA
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31
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Simpson JM. Three-dimensional echocardiography in congenital heart disease: The next steps. Arch Cardiovasc Dis 2016; 109:81-3. [DOI: 10.1016/j.acvd.2015.09.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Revised: 09/22/2015] [Accepted: 09/24/2015] [Indexed: 10/22/2022]
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32
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Yamamoto Y, Ohara T, Funada A, Takahama H, Amaki M, Hasegawa T, Sugano Y, Kanzaki H, Anzai T. Intracardiac echocardiography to diagnose pannus formation after aortic valve replacement. J Echocardiogr 2016; 14:39-41. [PMID: 26732266 DOI: 10.1007/s12574-015-0272-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2015] [Revised: 12/19/2015] [Accepted: 12/21/2015] [Indexed: 11/24/2022]
Abstract
A 66-year-old female, under regular follow-up for 20 years after aortic valve replacement (19-mm Carbomedics), presented dyspnea on effort and hypotension during hemodialysis. A transthoracic echocardiogram showed elevation of transvalvular velocity up to 4 m/s, but the structure around the aortic prosthesis was difficult to observe due to artifacts. Fluoroscopy revealed normal motion of the leaflets of the mechanical valve. Intracardiac echocardiography (ICE) revealed a pannus-like structure in the left ventricular outflow tract. Transesophageal echocardiogram also revealed this structure. ICE can visualize structural abnormalities around a prosthetic valve after cardiac surgery even in patients in whom conventional imaging modalities failed.
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Affiliation(s)
- Yoshiya Yamamoto
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, 5-7-1 Fujishiro-dai, Suita, Osaka, 565-8565, Japan
| | - Takahiro Ohara
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, 5-7-1 Fujishiro-dai, Suita, Osaka, 565-8565, Japan.
| | - Akira Funada
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, 5-7-1 Fujishiro-dai, Suita, Osaka, 565-8565, Japan
| | - Hiroyuki Takahama
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, 5-7-1 Fujishiro-dai, Suita, Osaka, 565-8565, Japan
| | - Makoto Amaki
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, 5-7-1 Fujishiro-dai, Suita, Osaka, 565-8565, Japan
| | - Takuya Hasegawa
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, 5-7-1 Fujishiro-dai, Suita, Osaka, 565-8565, Japan
| | - Yasuo Sugano
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, 5-7-1 Fujishiro-dai, Suita, Osaka, 565-8565, Japan
| | - Hideaki Kanzaki
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, 5-7-1 Fujishiro-dai, Suita, Osaka, 565-8565, Japan
| | - Toshihisa Anzai
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, 5-7-1 Fujishiro-dai, Suita, Osaka, 565-8565, Japan
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Hamid N, Ewe SH. Interventional Echocardiography: Current Role and Progress. PROCEEDINGS OF SINGAPORE HEALTHCARE 2015. [DOI: 10.1177/201010581502400102] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Advances in cardiovascular interventional techniques have enabled percutaneous treatment for a wide spectrum of non-coronary cardiovascular diseases, also known as ‘structural heart diseases (SHD)’. As these therapies are performed without an open-heart surgery, the use of echocardiography is crucial for detailed visualisation of cardiac anatomy, and to provide guidance for optimal success of these catheter-based interventions. This review will describe the key role of the echocardiographic techniques and imaging protocols that are currently used in different catheter-based SHD interventions.
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Affiliation(s)
- Nadira Hamid
- Department of Cardiology, National Heart Centre Singapore, Singapore
| | - See Hooi Ewe
- Department of Cardiology, National Heart Centre Singapore, Singapore
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Anwaruddin S. The Role of Preoperative and Intraoperative Imaging in Guiding Transcatheter Aortic Valve Replacement. Interv Cardiol Clin 2015; 4:39-51. [PMID: 28582121 DOI: 10.1016/j.iccl.2014.09.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Optimal intraprocedural imaging is central to transcatheter aortic valve replacement (TAVR). Familiarity with commonly used modalities is necessary. Real-time, intraprocedural imaging is provided by fluoroscopy and echocardiography to ensure proper valve position and deployment, and to assess for postdeployment complications. By providing anatomic information to real-time fluoroscopy, fusion imaging has the potential to positively affect TAVR. As newer generation valves are introduced and as TAVR is potentially offered to lower risk patient populations, it will be important to ensure that improvements in intraprocedural imaging lead to better outcomes.
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Affiliation(s)
- Saif Anwaruddin
- Transcatheter Valve Program, Hospital of the University of Pennsylvania, University of Pennsylvania School of Medicine, Philadelphia, PA, USA.
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