Abstract
Fusion of different imaging modalities has gained increasing popularity over the last decade. However, most fusions are done between static rather than dynamic images. In order to adequately visualize the complex three-dimensional structures of the beating heart, high-temporal and spatial image resolutions are mandatory. Currently, only the combination of transesophageal echocardiography with fluoroscopy allows real-time image fusion of high quality during structural heart disease (SHD) interventions. The use of markers as well as real-time image overlay greatly facilitates communication between SHD team members and potentially increases procedural success while reducing radiation dose and use of contrast. However, to date there is only limited evidence that fusion imaging improves safety and outcomes of SHD interventions. This review highlights the benefits of fusion imaging during SHD interventions such as transseptal puncture and closure of atrial septal defects and left atrial appendage as well as interventions on the mitral and aortic valve.
Highlights
Significant valvular heart disease increases with advancing age, reaching a prevalence of 11.7 % of those aged 75 years or older [1]
Numerous less invasive therapies such as percutaneous or transcatheter interventions have recently been introduced for treatment of structural heart disease (SHD)
Already new transcatheter options such as percutaneous mitral annuloplasty ring implantation or transcatheter mitral valve replacement appear on the horizon [8, 9]
Summary
Significant valvular heart disease increases with advancing age, reaching a prevalence of 11.7 % of those aged 75 years or older [1]. Surgery is indicated in many of these patients, but the perioperative mortality and morbidity risk increases in this aging and often comorbid population [2]. Numerous less invasive therapies such as percutaneous or transcatheter interventions have recently been introduced for treatment of structural heart disease (SHD). Transcatheter aortic valve replacement (TAVR) has proven to be or more effective than surgical aortic valve replacement for high-risk surgical patients [3, 4]. New devices effectively close the left atrial appendage and reduce the risk of thromboembolic complications in atrial fibrillation and even reduce mortality [5].
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