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Kassab J, Miyasaka RL, Harb SC. Advanced Echocardiographic Guidance for Transcatheter Tricuspid Edge-To-Edge Repair. Cardiol Clin 2024; 42:351-360. [PMID: 38910020 DOI: 10.1016/j.ccl.2024.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/25/2024]
Abstract
Echocardiography, in all its forms (transthoracic echocardiography [TTE], transesophageal echocardiography [TEE], and intracardiac echocardiography [ICE]), is pivotal for the evaluation, guidance, and follow-up of transcatheter tricuspid edge-to-edge repair (TV-TEER) therapies. Although two-dimensional (2D) echocardiography remains essential, three-dimensional (3D) echo with multiplanar reconstruction (MPR) has revolutionized the field of structural imaging. In addition, the advent of 3D ICE has added an important modality to the imaging toolbox, particularly helpful when intraprocedural TEE images are challenging. In this review, we provide a detailed, step-by-step approach for advanced echocardiographic guidance of TV-TEER using 3D MPR.
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Affiliation(s)
- Joseph Kassab
- Heart, Vascular and Thoracic Institute, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Rhonda L Miyasaka
- Heart, Vascular and Thoracic Institute, Cleveland Clinic Foundation, Cleveland, OH, USA; Department of Cardiovascular Medicine, Cleveland Clinic Foundation, 9500 Euclid Avenue, J2-3, Cleveland, OH 44195, USA
| | - Serge C Harb
- Heart, Vascular and Thoracic Institute, Cleveland Clinic Foundation, Cleveland, OH, USA; Department of Cardiovascular Medicine, Cleveland Clinic Foundation, 9500 Euclid Avenue, J2-3, Cleveland, OH 44195, USA.
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Sharkey A, Khan AA, Yunus R, Rehman T, Bu Y, Saeed S, Matyal R, Mahmood F. Advancing Precision in 3D Echocardiography: Incorporating 3D Markers to Aid Spatial Orientation. J Cardiothorac Vasc Anesth 2024:S1053-0770(24)00320-3. [PMID: 38918095 DOI: 10.1053/j.jvca.2024.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 05/05/2024] [Accepted: 05/10/2024] [Indexed: 06/27/2024]
Abstract
The incorporation of 3D imaging into diagnostic and interventional echocardiography has rapidly expanded in recent years. Applications such as multiplanar reconstruction that were once considered research tools and required off-cart analysis can now readily be performed at the point of image acquisition and in real-time during live image acquisition for procedural guidance. While the application and quality of 3D images have significantly improved in recent years, there remains a noticeable lag in the evolution of artificial intelligence that would further simplify the interpretative processes, both during live sessions and offline analyses. Users are still required to mentally reconstruct sliced images during multiplanar reconstruction based on color-coded planes. While this may be an effortless task for the seasoned echocardiographer, it can be a challenging task for echocardiographers who are less familiar with 3D imaging and multiplanar reconstruction. This article describes the utility of using 3D markers to aid in image interpretation.
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Affiliation(s)
- Aidan Sharkey
- Department of Anesthesia, Critical Care and Pain Medicine Department, Beth Israel Deaconess Medical Center, Boston, MA, 02215.
| | - Adnan A Khan
- Department of Anesthesia, Critical Care and Pain Medicine Department, Beth Israel Deaconess Medical Center, Boston, MA, 02215
| | - Rayaan Yunus
- Department of Anesthesia, Critical Care and Pain Medicine Department, Beth Israel Deaconess Medical Center, Boston, MA, 02215
| | - Taha Rehman
- Department of Anesthesia, Critical Care and Pain Medicine Department, Beth Israel Deaconess Medical Center, Boston, MA, 02215
| | - Yifan Bu
- Department of Anesthesia, Critical Care and Pain Medicine Department, Beth Israel Deaconess Medical Center, Boston, MA, 02215
| | - Shirin Saeed
- Department of Anesthesia, Critical Care and Pain Medicine Department, Beth Israel Deaconess Medical Center, Boston, MA, 02215
| | - Robina Matyal
- Department of Anesthesia, Critical Care and Pain Medicine Department, Beth Israel Deaconess Medical Center, Boston, MA, 02215
| | - Feroze Mahmood
- Department of Anesthesia, Critical Care and Pain Medicine Department, Beth Israel Deaconess Medical Center, Boston, MA, 02215
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Voudris K, Lesser J, Sorajja P, Hamid N. 3-Dimensional Multiplanar Reconstruction With Transesophageal Echocardiography for Alcohol Septal Ablation. JACC Case Rep 2023; 24:102016. [PMID: 37869218 PMCID: PMC10589419 DOI: 10.1016/j.jaccas.2023.102016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 05/22/2023] [Accepted: 08/14/2023] [Indexed: 10/24/2023]
Abstract
This study described the first experience with 3-dimensional multiplanar reconstruction transesophageal echocardiography to guide percutaneous alcohol septal ablation. This study demonstrated that 3-dimensional transesophageal echocardiography multiplanar reconstruction allowed for simultaneous assessment of the targeted myocardial area from left ventricular base to apex, akin to imaging seen with spatial imaging with cardiac magnetic resonance. (Level of Difficulty: Intermediate.).
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Affiliation(s)
- Konstaninos Voudris
- Valve Science Center, Minneapolis Heart Institute Foundation, Minneapolis, Minnesota, USA
| | - John Lesser
- Valve Science Center, Minneapolis Heart Institute Foundation, Minneapolis, Minnesota, USA
| | - Paul Sorajja
- Valve Science Center, Minneapolis Heart Institute Foundation, Minneapolis, Minnesota, USA
| | - Nadira Hamid
- Valve Science Center, Minneapolis Heart Institute Foundation, Minneapolis, Minnesota, USA
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Gartman CH, Pospishil L, Neuburger PJ. Recommendations for Transesophageal Echocardiographic Screening in Transcatheter Left Atrial Appendage Exclusion, Interatrial Septum, and Interventricular Septum Interventions: Insights for the Cardiothoracic Anesthesiologist. J Cardiothorac Vasc Anesth 2023:S1053-0770(23)00322-1. [PMID: 37286399 DOI: 10.1053/j.jvca.2023.05.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 05/07/2023] [Indexed: 06/09/2023]
Affiliation(s)
- Charles H Gartman
- Department of Anesthesiology & Critical Care, Hospital of the University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA
| | - Liliya Pospishil
- Department of Anesthesiology, Perioperative Care and Pain Medicine, New York University Grossman School of Medicine, New York, NY.
| | - Peter J Neuburger
- Department of Anesthesiology, Perioperative Care and Pain Medicine, New York University Grossman School of Medicine, New York, NY
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Gartman CH, Feinman J. Real-Time Multiplanar Reconstruction As a Standard Imaging Modality for Structural Heart Procedural Guidance. J Cardiothorac Vasc Anesth 2023; 37:582-583. [PMID: 36717314 DOI: 10.1053/j.jvca.2022.12.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 12/29/2022] [Indexed: 01/09/2023]
Affiliation(s)
| | - Jared Feinman
- Hospital of the University of Pennsylvania, Philadelphia, PA
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Jost ZT, Nooli NP, Ali AE, Jaganathan V, Nanda NC. Three-dimensional echocardiography of the tricuspid valve. Front Cardiovasc Med 2023; 10:1114715. [PMID: 37020521 PMCID: PMC10067886 DOI: 10.3389/fcvm.2023.1114715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 02/24/2023] [Indexed: 03/22/2023] Open
Abstract
Due to the proportionally high mortality rates associated with isolated tricuspid valve surgery, the invasive treatment of such pathology, historically, has been left largely unaddressed. Recently, there has been an appreciation for the mortality and morbidity of tricuspid valve disease, giving rise to the movement towards identifying less invasive, transcatheter approaches for treatment. Due to the technical complexity of these procedures along with the uniqueness and variability of tricuspid valve anatomy, a better appreciation of the tricuspid valve anatomy and pathology is required for pre-procedural planning. While two-dimensional echocardiography serves as the initial non-invasive modality for tricuspid valve evaluation, three-dimensional echocardiography provides a complete en face view of the tricuspid valve and surrounding structures, as well contributes further information regarding disease etiology and severity. In this review, we discuss the utility of three-dimensional echocardiography as a supplement to two-dimensional imaging to better assess tricuspid valve disease and anatomy to aide in future innovative therapies.
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Affiliation(s)
- Zachary T. Jost
- Department of Internal Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
- Correspondence: Zachary T. Jost Navin C. Nanda
| | - Nishank P. Nooli
- Division of Cardiothoracic Anesthesia, Department of Anesthesiology and Perioperative Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Ahmed E. Ali
- Division of Cardiovascular Disease, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Vijayadithyan Jaganathan
- Division of Cardiovascular Disease, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Navin C. Nanda
- Division of Cardiovascular Disease, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
- Correspondence: Zachary T. Jost Navin C. Nanda
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