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Squara F, Bres M, Baudouy D, Schouver ED, Moceri P, Ferrari E. Transesophageal echocardiography for the assessment of left atrial appendage thrombus: Study of the additional value of systematic real time 3D imaging after regular 2D evaluation. Echocardiography 2018; 35:474-480. [PMID: 29399868 DOI: 10.1111/echo.13813] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Two-dimensional transesophageal echocardiography (2DTEE) is currently validated for left atrial appendage (LAA) thrombus assessment but has some limitations. AIMS To evaluate the performance and interest of systematic real time three-dimensional transesophageal echocardiography (3DTEE) for LAA thrombus assessment, when performed after 2DTEE. METHODS AND RESULTS Consecutive patients undergoing TEE were prospectively included. LAA was first evaluated using 2DTEE, and patients were classified as "2D-NT" if no thrombus was found, "2D-T" in case of clear thrombus, or "2D-EQ" if equivocal. Then, 3DTEE of the LAA was performed and patients were similarly classified as "3D-NT," "3D-T," or "3D-EQ." Additional LAA CT scan was only performed if LAA thrombus was not clearly ruled out or confirmed by TEE. Additional value of 3DTEE after 2DTEE LAA evaluation was then assessed. We included 104 patients undergoing TEE. Agreement between 2DTEE and 3DTEE was very good for thrombus diagnosis (k = 0.936), but moderate for vacant LAA (k = 0.562) due to more frequent 2D-EQ than 3D-EQ (11.5% vs 2.9%; P = .016). 3DTEE allowed to refine the LAA status in 11 of 12 (91.7%) 2D-EQ patients: 10 3D-NT, 1 3D-T, and 1 3D-EQ. Coupling 3DTEE to 2DTEE permitted a definite LAA diagnosis in 103 of 104 (99%) vs 92 of 104 (88.5%) patients when 2DTEE was used alone (P = .002). Nine (8.7%) LAA thrombi were diagnosed, and 3 CT scan were performed. CONCLUSION 3DTEE of the LAA is more effective for thrombus assessment than 2DTEE. 3DTEE should be particularly considered in case of equivocal 2DTEE, as it allows to reach a definite LAA diagnosis in almost all of the patients.
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Affiliation(s)
- Fabien Squara
- Cardiology Department, Pasteur University Hospital, Nice, France
| | - Mikael Bres
- Cardiology Department, Pasteur University Hospital, Nice, France
| | - Delphine Baudouy
- Cardiology Department, Pasteur University Hospital, Nice, France
| | | | - Pamela Moceri
- Cardiology Department, Pasteur University Hospital, Nice, France
| | - Emile Ferrari
- Cardiology Department, Pasteur University Hospital, Nice, France
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2
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Jone PN, Ross MM, Bracken JA, Mulvahill MJ, Di Maria MV, Fagan TE. Feasibility and Safety of Using a Fused Echocardiography/Fluoroscopy Imaging System in Patients with Congenital Heart Disease. J Am Soc Echocardiogr 2016; 29:513-21. [PMID: 27143284 DOI: 10.1016/j.echo.2016.03.014] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2016] [Indexed: 01/09/2023]
Abstract
BACKGROUND Fused real-time three-dimensional transesophageal echocardiography and fluoroscopy has been used in adult patients during percutaneous mitral valve and aortic valve procedures. The use of fused echocardiographic/x-ray fluoroscopic imaging (FEX) in pediatric patients undergoing congenital heart disease catheterization has not been evaluated for feasibility and safety. The aims of this study were to assess the feasibility and safety of FEX for interventional guidance and to perform a comparison of atrial septal defect (ASD) device closure using this technology with traditional guidance methods. METHODS Prospective evaluation of FEX in congenital cardiac interventions was conducted. A subset of patients with ASD closures were compared with patients with historical ASD closures with and without FEX. The interventionalist and echocardiographer rated the anatomic quality of the fusion imaging as (1) excellent, (2) good, or (3) poor. In addition, the utility of FEX procedural guidance was graded as (1) superior, (2) no added benefit, or (3) inferior to that of standard guidance by fluoroscopy and transesophageal echocardiography. RESULTS FEX was successfully used in 26 procedures on 25 patients with congenital heart disease from January 2013 to February 2015. The median age was 9 years (range, 3-26 years), and the median weight was 29 kg (range, 16-77 kg). Twenty-six procedures were performed, including ASD closure, Fontan fenestration closure, and transcatheter valve placement in the tricuspid valve position. There was reduced fluoroscopy time and radiation dose in patients with ASDs who underwent imaging using this new technology (P < .001 and P < .03, respectively). There were no statistically significant differences in procedural times between the two groups. Anatomic definition was rated as excellent in 20 of 26 procedures, with the remaining six rated was good. Twenty-one of 26 procedures were graded as superior (81%), and five of 26 (19%) were graded as providing no added benefit. There were no complications in any of the procedures. CONCLUSIONS In this early experience, FEX is feasible and safe in patients undergoing congenital heart disease catheterization and provides useful guidance in the majority of interventional procedures. There were relative reductions in fluoroscopy time and radiation dose with the use of FEX for ASD closure.
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Affiliation(s)
- Pei-Ni Jone
- Pediatric Cardiology, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, Colorado.
| | - Michael M Ross
- Pediatric Cardiology, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, Colorado
| | - John A Bracken
- Philips Research North America, Briarcliff Manor, New York
| | - Matthew J Mulvahill
- Department of Pediatrics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Michael V Di Maria
- Pediatric Cardiology, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, Colorado
| | - Thomas E Fagan
- Pediatric Cardiology, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, Colorado
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Nillesen MM, van Dijk APJ, Duijnhouwer AL, Thijssen JM, de Korte CL. Automated Assessment of Right Ventricular Volumes and Function Using Three-Dimensional Transesophageal Echocardiography. ULTRASOUND IN MEDICINE & BIOLOGY 2016; 42:596-606. [PMID: 26633596 DOI: 10.1016/j.ultrasmedbio.2015.10.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Revised: 09/23/2015] [Accepted: 10/20/2015] [Indexed: 06/05/2023]
Abstract
Assessment of right ventricular (RV) function is known to be of diagnostic value in patients with RV dysfunction. Because of its complex anatomic shape, automated determination of the RV volume is difficult and strong reliance on geometric assumptions is not desired. A method for automated RV assessment was developed using three-dimensional (3-D) echocardiography without relying on a priori knowledge of the cardiac anatomy. A 3-D adaptive filtering technique that optimizes the discrimination between blood and myocardium was applied to facilitate endocardial border detection. Filtered image data were incorporated in a segmentation model to automatically detect the endocardial RV border. End-systolic and end-diastolic RV volumes, as well as ejection fraction, were computed from the automatically segmented endocardial surfaces and compared against reference volumes manually delineated by two expert cardiologists. The results reported good performance in terms of correlation and agreement with the results from the reference volumes.
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Affiliation(s)
- Maartje M Nillesen
- Medical UltraSound Imaging Center (MUSIC), Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, The Netherlands.
| | - Arie P J van Dijk
- Department of Cardiology, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | - Johan M Thijssen
- Medical UltraSound Imaging Center (MUSIC), Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Chris L de Korte
- Medical UltraSound Imaging Center (MUSIC), Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
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Jungen C, Zeus T, Balzer J, Eickholt C, Petersen M, Kehmeier E, Veulemans V, Kelm M, Willems S, Meyer C. Left Atrial Appendage Closure Guided by Integrated Echocardiography and Fluoroscopy Imaging Reduces Radiation Exposure. PLoS One 2015; 10:e0140386. [PMID: 26465747 PMCID: PMC4605826 DOI: 10.1371/journal.pone.0140386] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Accepted: 09/22/2015] [Indexed: 02/02/2023] Open
Abstract
Aims To investigate whether percutaneous left atrial appendage (LAA) closure guided by automated real-time integration of 2D-/3D-transesophageal echocardiography (TEE) and fluoroscopy imaging results in decreased radiation exposure. Methods and Results In this open-label single-center study LAA closure (AmplatzerTM Cardiac Plug) was performed in 34 consecutive patients (8 women; 73.1±8.5 years) with (n = 17, EN+) or without (n = 17, EN-) integrated echocardiography/fluoroscopy imaging guidance (EchoNavigator® [EN]; Philips Healthcare). There were no significant differences in baseline characteristics between both groups. Successful LAA closure was documented in all patients. Radiation dose was reduced in the EN+ group about 52% (EN+: 48.5±30.7 vs. EN-: 93.9±64.4 Gy/cm2; p = 0.01). Corresponding to the radiation dose fluoroscopy time was reduced (EN+: 16.7±7 vs. EN-: 24.0±11.4 min; p = 0.035). These advantages were not at the cost of increased procedure time (89.6±28.8 vs. 90.1±30.2 min; p = 0.96) or periprocedural complications. Contrast media amount was comparable between both groups (172.3±92.7 vs. 197.5±127.8 ml; p = 0.53). During short-term follow-up of at least 3 months (mean: 8.1±5.9 months) no device-related events occurred. Conclusions Automated real-time integration of echocardiography and fluoroscopy can be incorporated into procedural work-flow of percutaneous left atrial appendage closure without prolonging procedure time. This approach results in a relevant reduction of radiation exposure. Trial Registration ClinicalTrials.gov NCT01262508
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Affiliation(s)
- Christiane Jungen
- Department of Cardiology—Electrophysiology, cNEP, cardiac Neuro- and Electrophysiology research group, University Heart Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany, DZHK (German Center for Cardiovascular Research), partner site Hamburg/Kiel/Luebeck, Hamburg, Germany
- Department of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, University Hospital Duesseldorf, Duesseldorf, Germany
| | - Tobias Zeus
- Department of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, University Hospital Duesseldorf, Duesseldorf, Germany
| | - Jan Balzer
- Department of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, University Hospital Duesseldorf, Duesseldorf, Germany
| | - Christian Eickholt
- Department of Cardiology—Electrophysiology, cNEP, cardiac Neuro- and Electrophysiology research group, University Heart Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany, DZHK (German Center for Cardiovascular Research), partner site Hamburg/Kiel/Luebeck, Hamburg, Germany
- Department of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, University Hospital Duesseldorf, Duesseldorf, Germany
| | - Margot Petersen
- Department of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, University Hospital Duesseldorf, Duesseldorf, Germany
| | - Eva Kehmeier
- Department of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, University Hospital Duesseldorf, Duesseldorf, Germany
| | - Verena Veulemans
- Department of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, University Hospital Duesseldorf, Duesseldorf, Germany
| | - Malte Kelm
- Department of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, University Hospital Duesseldorf, Duesseldorf, Germany
| | - Stephan Willems
- Department of Cardiology—Electrophysiology, cNEP, cardiac Neuro- and Electrophysiology research group, University Heart Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany, DZHK (German Center for Cardiovascular Research), partner site Hamburg/Kiel/Luebeck, Hamburg, Germany
| | - Christian Meyer
- Department of Cardiology—Electrophysiology, cNEP, cardiac Neuro- and Electrophysiology research group, University Heart Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany, DZHK (German Center for Cardiovascular Research), partner site Hamburg/Kiel/Luebeck, Hamburg, Germany
- Department of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, University Hospital Duesseldorf, Duesseldorf, Germany
- * E-mail:
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Guarracino F, Baldassarri R, Ferro B, Giannini C, Bertini P, Petronio AS, Di Bello V, Landoni G, Alfieri O. Transesophageal Echocardiography During MitraClip® Procedure. Anesth Analg 2014; 118:1188-96. [DOI: 10.1213/ane.0000000000000215] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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6
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Eng MH, Salcedo EE, Kim M, Quaife RA, Carroll JD. Implementation of real-time three-dimensional transesophageal echocardiography for mitral balloon valvuloplasty. Catheter Cardiovasc Interv 2013; 82:994-8. [DOI: 10.1002/ccd.25052] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2013] [Revised: 05/23/2013] [Accepted: 06/01/2013] [Indexed: 11/10/2022]
Affiliation(s)
- Marvin H. Eng
- Department of Medicine, Division of Cardiology, University of Texas Health Sciences Center; San Antonio Texas
| | - Ernesto E. Salcedo
- Department of Medicine, Division of Cardiology, University of Colorado Denver; Aurora Colorado
| | - Michael Kim
- Department of Medicine, Division of Cardiology, University of Colorado Denver; Aurora Colorado
| | - Robert A. Quaife
- Department of Medicine, Division of Cardiology, University of Colorado Denver; Aurora Colorado
| | - John D. Carroll
- Department of Medicine, Division of Cardiology, University of Colorado Denver; Aurora Colorado
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Rostamian A, Rathod A, Makkar RR, Siegel RJ. Three-Dimensional Echocardiographic Assessment of Patent Foramen Ovale in Platypnea-Orthodeoxia. Echocardiography 2013; 30:E239-42. [DOI: 10.1111/echo.12265] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Affiliation(s)
- Armand Rostamian
- Heart Institute; Cedars-Sinai Medical Center; Los Angeles; California
| | - Ankit Rathod
- Heart Institute; Cedars-Sinai Medical Center; Los Angeles; California
| | | | - Robert J. Siegel
- Heart Institute; Cedars-Sinai Medical Center; Los Angeles; California
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8
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Beat to beat 3-dimensional intracardiac echocardiography: theoretical approach and practical experiences. Int J Cardiovasc Imaging 2012; 29:753-64. [DOI: 10.1007/s10554-012-0136-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2012] [Accepted: 10/03/2012] [Indexed: 11/25/2022]
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9
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Vasilyev NV, Dupont PE, del Nido PJ. Robotics and imaging in congenital heart surgery. Future Cardiol 2012; 8:285-96. [PMID: 22413986 DOI: 10.2217/fca.12.20] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
The initial success seen in adult cardiac surgery with the application of available robotic systems has not been realized as broadly in pediatric cardiac surgery. The main obstacles include extended set-up time and complexity of the procedures, as well as the large size of the instruments with respect to the size of the child. Moreover, while the main advantage of robotic systems is the ability to minimize incision size, for intracardiac repairs, cardiopulmonary bypass is still required. Catheter-based interventions, on the other hand, have expanded rapidly in both application as well as the complexity of procedures and lesions being treated. However, despite the development of sophisticated devices, robotic systems to aid catheter procedures have not been commonly applied in children. In this article, we describe new catheter-like robotic delivery platforms, which facilitate safe navigation and enable complex repairs, such as tissue approximation and fixation, and tissue removal, inside the beating heart. Additional features including the tracking of rapidly moving tissue targets and novel imaging approaches are described, along with a discussion of future prospects for steerable robotic systems.
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10
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Stoll J, Ren H, Dupont PE. Passive markers for tracking surgical instruments in real-time 3-D ultrasound imaging. IEEE TRANSACTIONS ON MEDICAL IMAGING 2012; 31:563-575. [PMID: 22042148 PMCID: PMC3638948 DOI: 10.1109/tmi.2011.2173586] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
A family of passive echogenic markers is presented by which the position and orientation of a surgical instrument can be determined in a 3-D ultrasound volume, using simple image processing. Markers are attached near the distal end of the instrument so that they appear in the ultrasound volume along with the instrument tip. They are detected and measured within the ultrasound image, thus requiring no external tracking device. This approach facilitates imaging instruments and tissue simultaneously in ultrasound-guided interventions. Marker-based estimates of instrument pose can be used in augmented reality displays or for image-based servoing. Design principles for marker shapes are presented that ensure imaging system and measurement uniqueness constraints are met. An error analysis is included that can be used to guide marker design and which also establishes a lower bound on measurement uncertainty. Finally, examples of marker measurement and tracking algorithms are presented along with experimental validation of the concepts.
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Affiliation(s)
- Jeffrey Stoll
- Ultrasound Division, Siemens Healthcare, Mountain View, CA 94043, USA.
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11
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Sustained risk of recurrent thromboembolic events in patients with patent foramen ovale and paradoxical embolism: long-term follow-up over more than 15 years. Clin Res Cardiol 2011; 101:297-303. [DOI: 10.1007/s00392-011-0392-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2011] [Accepted: 11/29/2011] [Indexed: 12/25/2022]
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12
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Agricola E, Badano L, Mele D, Galderisi M, Slavich M, Sciomer S, Nistri S, Ballo P, D'Andrea A, Mondillo S. Real-time three dimensional transesophageal echocardiography: technical aspects and clinical applications. Heart Int 2011; 5:e6. [PMID: 21977291 PMCID: PMC3184702 DOI: 10.4081/hi.2010.e6] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2010] [Accepted: 04/06/2010] [Indexed: 11/22/2022] Open
Abstract
Real-time three-dimensional transesophageal echocardiography (RT3DTEE) is now commonly used in daily clinical practice. The transesophageal, compared to the transthoracic approach, allows the visualization of the whole spectrum of the mitral valve apparatus and the posterior cardiac structures. Moreover, images obtained by RT 3D TEE provide a unique and complete visualization of the mitral valve prosthetic elements. Indeed, the possibility to visualize guidewires and catheters in cardiac chambers and their relationship with cardiac structures during percutaneous transcatheter procedures reduces the time of radiation exposure and simplifies the approach becoming the reference method for monitoring. This review aims to underline the potential clinical applications and the advantages of RT3DTEE compared to other methods.
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Affiliation(s)
- Eustachio Agricola
- Division of Non-Invasive Cardiology, Cardiothoracic Department, San Raffaele Hospital, Milano, Italy
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13
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Real-time three-dimensional echocardiography during percutaneous edge-to-edge mitral valve repair. J Cardiovasc Echogr 2011. [DOI: 10.1016/j.jcecho.2011.05.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Fusini L, Tamborini G, Gripari P, Maffessanti F, Mazzanti V, Muratori M, Salvi L, Sisillo E, Caiani EG, Alamanni F, Fiorentini C, Pepi M. Feasibility of Intraoperative Three-Dimensional Transesophageal Echocardiography in the Evaluation of Right Ventricular Volumes and Function in Patients Undergoing Cardiac Surgery. J Am Soc Echocardiogr 2011; 24:868-77. [DOI: 10.1016/j.echo.2011.05.002] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2011] [Indexed: 10/18/2022]
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15
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Ibrahim K, Christoph M, Nicolai J, Schroetter H, Schmidt T, Kappert U, Schoen S, Strasser RH. Transapical septal occluder for paravalvular leakage of the mitral valve: a novel method for interventional treatment in high-risk patients. Clin Res Cardiol 2011; 100:809-10. [PMID: 21644053 DOI: 10.1007/s00392-011-0326-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2010] [Accepted: 05/23/2011] [Indexed: 11/24/2022]
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Anatomy of right atrial structures by real-time 3D transesophageal echocardiography. JACC Cardiovasc Imaging 2011; 3:966-75. [PMID: 20846634 DOI: 10.1016/j.jcmg.2010.03.014] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2010] [Revised: 03/18/2010] [Accepted: 03/23/2010] [Indexed: 12/31/2022]
Abstract
The rapid development of catheter ablation techniques for atrial arrhythmias has triggered a renewed interest in the anatomy of the right atrium. In particular, some atrial arrhythmias such as focal atrial arrhythmias or atrial flutter have been linked to the anatomic architecture of specific structures such as the crista terminalis or cavotricuspid isthmus. Real-time 3-dimensional transesophageal echocardiography (RT 3D TEE) is a recently developed technique that provides 3D images of unprecedented quality. Because the right atrium is very close to the transducer, this technique may provide high-quality images of those atrial structures involved in ablation procedures. This review describes a step-by-step approach for acquisition and processing of RT 3D TEE images of right atrial structures of relevance to electrophysiologists. For anatomical correlations of RT 3D TEE images, selected images of right atrial structures were matched to anatomical specimens.
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Altiok E, Becker M, Hamada S, Reith S, Marx N, Hoffmann R. Optimized guidance of percutaneous edge-to edge repair of the mitral valve using real-time 3-D transesophageal echocardiography. Clin Res Cardiol 2011; 100:675-81. [DOI: 10.1007/s00392-011-0296-1] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2010] [Accepted: 02/16/2011] [Indexed: 10/18/2022]
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18
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Simpson JM, Miller O. Three-dimensional echocardiography in congenital heart disease. Arch Cardiovasc Dis 2011; 104:45-56. [DOI: 10.1016/j.acvd.2010.11.004] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2010] [Revised: 11/15/2010] [Accepted: 11/16/2010] [Indexed: 01/17/2023]
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Mahjoub H, Noble S, Ibrahim R, Potvin J, O'Meara E, Dore A, Marcotte F, Crépeau J, Bonan R, Mansour A, Bouchard D, Ducharme A, Basmadjian AJ. Description and Assessment of a Common Reference Method for Fluoroscopic and Transesophageal Echocardiographic Localization and Guidance of Mitral Periprosthetic Transcatheter Leak Reduction. JACC Cardiovasc Interv 2011; 4:107-14. [DOI: 10.1016/j.jcin.2010.08.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2010] [Revised: 07/28/2010] [Accepted: 08/06/2010] [Indexed: 10/18/2022]
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20
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Three-Dimensional Echocardiography in Adult Congenital Heart Disease. CURRENT CARDIOVASCULAR IMAGING REPORTS 2010. [DOI: 10.1007/s12410-010-9038-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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21
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Non-compaction cardiomyopathy of the left ventricle diagnosed by cardiac magnetic resonance in a 2-generation family. Clin Res Cardiol 2010; 99:765-8. [DOI: 10.1007/s00392-010-0204-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2010] [Accepted: 08/03/2010] [Indexed: 10/19/2022]
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Three-Dimensional Transesophageal Echocardiography Is a Major Advance for Intraoperative Clinical Management of Patients Undergoing Cardiac Surgery. Anesth Analg 2010; 110:1548-73. [DOI: 10.1213/ane.0b013e3181d41be7] [Citation(s) in RCA: 92] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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24
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Gripari P, Tamborini G, Barbier P, Maltagliati AC, Galli CA, Muratori M, Salvi L, Sisillo E, Alamanni F, Pepi M. Real-time three-dimensional transoesophageal echocardiography: a new intraoperative feasible and useful technology in cardiac surgery. Int J Cardiovasc Imaging 2010; 26:651-60. [PMID: 20352342 DOI: 10.1007/s10554-010-9622-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2009] [Accepted: 03/11/2010] [Indexed: 10/19/2022]
Abstract
A new generation of transoesophageal echocardiographic probes with a novel matrix array technique has been recently introduced, allowing three-dimensional (3D) presentation of cardiac structures in real-time. This new tool may potentially provide fast and complete 3D information about cardiac structures improving spatial orientation and overcoming limitations of offline 3D technologies. The aim of this study was to demonstrate the feasibility and usefulness of real-time 3D transoesophageal echocardiography (TOE) for the intraoperative evaluation of cardiac surgery procedures. One-hundred patients underwent transoesophageal echocardiographic examination during cardiac surgery as a part of their routine clinical practice. In the intraoperative pre- and post-cardiopulmonary bypass periods complete 2D and 3D transoesophageal examinations were performed. Feasibility and duration of examinations, and immediate additional anatomical value of 3D versus 2D-TOE were annotated intraoperatively. Image quality, additional clinical value of 3D- compared to standard 2D-TOE and the accuracy in the description of mitral valve pathology by a surgeon and an echocardiographer were evaluated off-line. No complications related to transoesophageal examination occurred and successful intubation was achieved in all 100 patients. Therefore, 200 examinations were performed and analysed considering the pre- and post-cardiopulmonary bypass periods. The mean number of acquisitions per patient was 16 +/- 14, including 3D real-time, zoom, full-volume and colour full volume modalities. The duration of the 3D examination was 16 +/- 10 min and the mean image quality score 2.8 +/- 0.7 (in a scale 1-4). In 36 out of 100 cases (36%) 3D-TOE provided additional anatomical information. The surgeon evaluated 3D images easier and more accurately than 2D images (88% vs. 76% in the evaluation of mitral valve scallop). Real-time 3D TOE may be used routinely for the intraoperative evaluation of cardiac surgery. Imaging with this new probe facilitates intraoperative evaluation of several surgical procedures with an additional clinical value in selected cases.
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Affiliation(s)
- Paola Gripari
- Centro Cardiologico Monzino, IRCCS, Department of Cardiovascular Sciences, University of Milan, Via Parea 4, Milan, Italy.
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The year 2009 in Clinical Research in Cardiology. Clin Res Cardiol 2010. [DOI: 10.1007/s00392-010-0126-x] [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: 10/19/2022]
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26
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3D transesophageal echocardiography: a review of recent literature 2007–2009. Curr Opin Anaesthesiol 2010; 23:80-8. [DOI: 10.1097/aco.0b013e328334a6b3] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Current World Literature. Curr Opin Anaesthesiol 2010; 23:116-20. [DOI: 10.1097/aco.0b013e3283357df6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Wang J, Wang X, Xie M, He L, Lv Q, Wang L. Clinical value of stereoscopic three-dimensional echocardiography in assessment of atrial septal defects: feasibility and efficiency. 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 2009; 29:791-794. [PMID: 20037829 DOI: 10.1007/s11596-009-0624-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2008] [Indexed: 05/28/2023]
Abstract
Stereoscopic three-dimensional echocardiography(S-3DE) is a novel displaying technology based on real-time 3-dimensional echocardiography (RT-3DE). Our study was to evaluate the feasibility and efficiency of S-3DE in the diagnosis of atrial septal defect (ASD) and its use in the guidance for transcatheter ASD occlusion. Twelve patients with secundum ASD underwent RT-3DE examination and 9 of the 12 were subjected to transcatheter closure of ASD. Stereoscopic vision was generated with a high-performance volume renderer with red-green stereoscopic glasses. S-3DE was compared with standard RT-3D display for the assessment of the shape, size, and the surrounding tissues of ASD and for the guidance of ASD occlusion. The appearance rate of coronary sinus and the mean formation time of the IVC, SVC were compared. Our results showed that S-3DE could measure the diameter of ASD accurately and there was no significant difference in the measurements between S-3DE and standard 3D display (2.89+/-0.73 cm vs 2.85+/-0.72 cm, P>0.05; r=0.96, P<0.05). The appearance of coronary sinus for S-3DE was higher as compared with the standard 3D display (93.3% vs 100%). The mean time of the IVC, SVC for S-3DE monitor was slightly shorter than that of the standard 3D display (11.0+/-3.8 s vs 10.3+/-3.6 s, P>0.05). The mean completion time of interventional procedure was shortened with S-3DE display as compared with standard 3D display (17.3+/-3.1 min vs 23.0+/-3.9 min, P<0.05). Stereoscopic three-dimensional echocardiography could improve the visualization of three-dimensional echocardiography, facilitate the identification of the adjacent structures, decrease the time required for interventional manipulation. It may be a feasible, safe, and efficient tool for guiding transcatheter septal occlusion or the surgical interventions.
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Affiliation(s)
- Jing Wang
- Department of Ultrasonography, Union Hospital, Huazhong University of Science and Technology, Hubei Provincial Key Laboratory of Molecular Imaging, Wuhan 430022, China.
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Perk G, Lang RM, Garcia-Fernandez MA, Lodato J, Sugeng L, Lopez J, Knight BP, Messika-Zeitoun D, Shah S, Slater J, Brochet E, Varkey M, Hijazi Z, Marino N, Ruiz C, Kronzon I. Use of real time three-dimensional transesophageal echocardiography in intracardiac catheter based interventions. J Am Soc Echocardiogr 2009; 22:865-82. [PMID: 19647156 DOI: 10.1016/j.echo.2009.04.031] [Citation(s) in RCA: 135] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2008] [Indexed: 12/25/2022]
Abstract
BACKGROUND Real-time three-dimensional (RT3D) echocardiography is a recently developed technique that is being increasingly used in echocardiography laboratories. Over the past several years, improvements in transducer technologies have allowed development of a full matrix-array transducer that allows acquisition of pyramidal-shaped data sets. These data sets can be processed online and offline to allow accurate evaluation of cardiac structures, volumes, and mass. More recently, a transesophageal transducer with RT3D capabilities has been developed. This allows acquisition of high-quality RT3D images on transesophageal echocardiography (TEE). Percutaneous catheter-based procedures have gained growing acceptance in the cardiac procedural armamentarium. Advances in technology and technical skills allow increasingly complex procedures to be performed using a catheter-based approach, thus obviating the need for open-heart surgery. METHODS The authors used RT3D TEE to guide 72 catheter-based cardiac interventions. The procedures included the occlusion of atrial septal defects or patent foramen ovales (n=25), percutaneous mitral valve repair (e-valve clipping; n=3), mitral balloon valvuloplasty for mitral stenosis (n=10), left atrial appendage obliteration (n=11), left atrial or pulmonary vein ablation for atrial fibrillation (n=5), percutaneous closures of prosthetic valve dehiscence (n=10), percutaneous aortic valve replacement (n=6), and percutaneous closures of ventricular septal defects (n=2). In this review, the authors describe their experience with this technique, the added value over multiplanar two-dimensional TEE, and the pitfalls that were encountered. RESULTS The main advantages found for the use RT3D TEE during catheter-based interventions were (1) the ability to visualize the entire lengths of intracardiac catheters, including the tips of all catheters and the balloons or devices they carry, along with a clear depiction of their positions in relation to other cardiac structures, and (2) the ability to ability to demonstrate certain structures in an "en face" view, which is not offered by any other currently available real-time imaging technique, enabling appreciation of the exact nature of the lesion that is undergoing intervention. CONCLUSION RT3D TEE is a powerful new imaging tool that may become the technique of choice and the standard of care for guidance of selected percutaneous catheter-based procedures.
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Affiliation(s)
- Gila Perk
- New York University School of Medicine, Interventional Cardiology Department, Lenox Hill Heart and Vascular Institute, New York, New York 10016, USA.
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Salcedo EE, Quaife RA, Seres T, Carroll JD. A Framework for Systematic Characterization of the Mitral Valve by Real-Time Three-Dimensional Transesophageal Echocardiography. J Am Soc Echocardiogr 2009; 22:1087-99. [PMID: 19801300 DOI: 10.1016/j.echo.2009.07.007] [Citation(s) in RCA: 75] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2009] [Indexed: 11/28/2022]
Affiliation(s)
- Ernesto E Salcedo
- University of Colorado Denver, Denver, Colorado, Aurora, CO 80045, USA.
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Abstract
PURPOSE OF REVIEW Echocardiography in pediatric and congenital heart disease is a key diagnostic technique in patients with congenital heart disease. Due to new technological developments, it has become a rapidly evolving field. RECENT FINDINGS In this review, we focus on recent developments in standardization and validation of standard techniques in pediatric and congenital echocardiography. This is mainly related to standardization of image acquisition and normalization of measurements for body size. The rest of the review is focused on the application of three-dimensional echocardiography, tissue Doppler imaging and Speqle tracking techniques to pediatric heart disease. SUMMARY New developments in standardization of echocardiography, the introduction of three-dimensional echocardiography and new functional techniques such as tissue Doppler and Speqle tracking strengthen the position of pediatric echocardiography as the most important diagnostic tool for patients with congenital heart disease.
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Balzer J, van Hall S, Rassaf T, Böring YC, Franke A, Lang RM, Kelm M, Kühl HP. Feasibility, safety, and efficacy of real-time three-dimensional transoesophageal echocardiography for guiding device closure of interatrial communications: initial clinical experience and impact on radiation exposure. EUROPEAN JOURNAL OF ECHOCARDIOGRAPHY 2009; 11:1-8. [PMID: 19755469 DOI: 10.1093/ejechocard/jep116] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
AIMS Our aim was to assess the feasibility and safety of real-time (RT) three-dimensional (3D) transoesophageal echocardiography (TEE) for guiding transcatheter closure of interatrial communications and to evaluate its additional benefit over conventional 2D TEE in reducing radiation exposure for the patient. METHODS AND RESULTS Twenty-five patients undergoing device closure of their interatrial defect had the procedure guided by fluoroscopy, 2D TEE, and RT 3D TEE. We retrospectively compared this group with a historical control group in which interventional guidance was performed using fluoroscopy and 2D TEE alone. The application of RT 3D TEE allowed safe device deployment in all patients without any complications, resulting in a reduction of mean fluoroscopy time (10 +/- 6 to 6 +/- 4 min, P < 0.01), mean dose area product (DAP) (964 +/- 628 to 535 +/- 464 cGy cm(2), P < 0.01), and mean DAP per individual body surface area (494 +/- 317 to 273 +/- 221 cGy cm(2)/m(2), P < 0.01). CONCLUSION RT 3D TEE as an adjunct to 2D TEE is a feasible and safe tool to guide transcatheter device closure of interatrial communications, resulting in a reduction of radiation exposure. These data indicate that RT 3D TEE can be used to safely monitor interatrial defect closure in clinical routine.
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Affiliation(s)
- Jan Balzer
- Division of Cardiology, Pulmonology and Vascular Medicine, Heinrich-Heine-University Duesseldorf, Moorenstr. 5, D-40225 Düsseldorf, Germany.
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Jánosi RA, Kahlert P, Plicht B, Böse D, Wendt D, Thielmann M, Jakob H, Eggebrecht H, Erbel R, Buck T. Guidance of percutaneous transcatheter aortic valve implantation by real-time three-dimensional transesophageal echocardiography – A single-center experience. MINIM INVASIV THER 2009; 18:142-8. [PMID: 19431067 DOI: 10.1080/13645700902920833] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Latcu DG, Rinaldi JP, Saoudi N. Real-time three-dimensional transoesophageal echocardiography for diagnosis of left atrial appendage thrombus. EUROPEAN JOURNAL OF ECHOCARDIOGRAPHY 2009; 10:711-2. [DOI: 10.1093/ejechocard/jep076] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Percutaneous Closure of an Atrial Septal Defect Guided by Live Three-Dimensional Transesophageal Echocardiography. J Am Soc Echocardiogr 2009; 22:753.e1-3. [DOI: 10.1016/j.echo.2009.01.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2008] [Indexed: 11/19/2022]
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Percutaneous closure of complex atrial septum defect guided by real-time 3D transesophageal echocardiography. Clin Res Cardiol 2009; 98:455-6. [DOI: 10.1007/s00392-009-0024-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2009] [Accepted: 04/23/2009] [Indexed: 10/20/2022]
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Medrano López C, Guía Torrent JM, Rueda Núñez F, Moruno Tirado A. [Update on pediatric cardiology and congenital heart disease]. Rev Esp Cardiol 2009; 62 Suppl 1:39-52. [PMID: 19174049 DOI: 10.1016/s0300-8932(09)70040-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The fields of pediatric cardiology and congenital heart disease have experienced considerable progress in the last few years, with advances in new diagnostic and therapeutic techniques that can be applied at all stages of life from the fetus to the adult. This article reviews scientific publications in a number of areas that appeared between August 2007 and September 2008. In developed countries, congenital heart disease is becoming increasingly prevalent in nonpediatric patients, including pregnant women. Actions aimed at preventing coronary heart disease must be started early in infancy and should involve the promotion of a healthy diet and lifestyle. Recent developments in echocardiography include the introduction of three-dimensional echocardiography and of new techniques such as two-dimensional speckle tracking imaging, which can be used for both anatomical and functional investigations in patients with complex heart disease, including a univentricular heart. Progress has also occurred in fetal cardiology, with new data on prognosis and prognostic factors and developments in intrauterine interventions, though indications for these interventions have still to be established. Heart transplantation has become a routine procedure, supplemented in some cases by circulatory support devices. In catheter interventions, new devices have become available for the closure of atrial or ventricular septal defects and patent ductus arteriosus as well as for percutaneous pulmonary valve implantation. Surgery is also advancing, in some cases with hybrid techniques, particularly for the treatment of hypoplastic left heart syndrome. The article ends with a review of publications on cardiomyopathy, myocarditis and the treatment of bacterial endocarditis.
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Affiliation(s)
- Constancio Medrano López
- Cardiología Pediátrica, Hospital Infantil, Hospital General Universitario Gregorio Marañón, Madrid, España.
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Johri AM, Yared K, Durst R, Cubeddu RJ, Palacios IF, Picard MH, Passeri J. Three-dimensional echocardiography-guided repair of severe paravalvular regurgitation in a bioprosthetic and mechanical mitral valve. EUROPEAN JOURNAL OF ECHOCARDIOGRAPHY 2009; 10:572-5. [DOI: 10.1093/ejechocard/jep019] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Yared K, Baggish AL, Solis J, Durst R, Passeri JJ, Palacios IF, Picard MH. Echocardiographic Assessment of Percutaneous Patent Foramen Ovale and Atrial Septal Defect Closure Complications. Circ Cardiovasc Imaging 2009; 2:141-9. [DOI: 10.1161/circimaging.108.832436] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- Kibar Yared
- From the Division of Cardiology, Massachusetts General Hospital, Harvard Medical School, Boston, Mass
| | - Aaron L. Baggish
- From the Division of Cardiology, Massachusetts General Hospital, Harvard Medical School, Boston, Mass
| | - Jorge Solis
- From the Division of Cardiology, Massachusetts General Hospital, Harvard Medical School, Boston, Mass
| | - Ronen Durst
- From the Division of Cardiology, Massachusetts General Hospital, Harvard Medical School, Boston, Mass
| | - Jonathan J. Passeri
- From the Division of Cardiology, Massachusetts General Hospital, Harvard Medical School, Boston, Mass
| | - Igor F. Palacios
- From the Division of Cardiology, Massachusetts General Hospital, Harvard Medical School, Boston, Mass
| | - Michael H. Picard
- From the Division of Cardiology, Massachusetts General Hospital, Harvard Medical School, Boston, Mass
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Balzer J, Kelm M, Kühl HP. Real-time three-dimensional transoesophageal echocardiography for guidance of non-coronary interventions in the catheter laboratory. EUROPEAN JOURNAL OF ECHOCARDIOGRAPHY 2009; 10:341-9. [PMID: 19211569 DOI: 10.1093/ejechocard/jep006] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Jan Balzer
- Department of Cardiology, Pulmonology, and Vascular Medicine, University Hospital RWTH Aachen, Germany
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Biner S, Rafique AM, Kar S, Siegel RJ. Live Three-Dimensional Transesophageal Echocardiography-Guided Transcatheter Closure of a Mitral Paraprosthetic Leak by Amplatzer Occluder. J Am Soc Echocardiogr 2008; 21:1282.e7-9. [DOI: 10.1016/j.echo.2008.07.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2008] [Indexed: 11/25/2022]
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