Technical Recommendations for Real-Time Echocardiography and Fluoroscopy Imaging Fusion in Catheter-Based Mitral Valve Paravalvular Leak and Other Procedures.

Robertas Stasys Samalavičius,Kęstutis Ručinskas,Vilius Janušauskas,Diana Zakarkaitė,Aleksejus Zorinas,Donatas Austys,Lina Puodžiukaitė,Eustaquio Maria Onorato,Ieva Jovaišienė,Giedrius Davidavičius,Gitana Zuozienė

doi:10.3390/jcm11051328

Abstract

Widespread catheter-based interventions for structural heart disease have overtaken the treatment of paravalvular leaks (PVL). Multimodality imaging techniques play a crucial role in accurate diagnosis, procedure planning and performance. However, PVL closure is often technically challenging due to the complex anatomy of the defects and their relation to surrounding anatomical structures. The application of echocardiography and fluoroscopy imaging fusion (EFF) may simplify challenging imaginative three-dimensional reconstruction of the intracardiac anatomy and facilitate the procedure. To master new technology, personnel must make cognitive changes, overcome a learning curve, and obtain adequate theoretical knowledge. Main aim of this manuscript is to present basic recommendations for EFF application in practice, alongside, each scenario is supported by technically challenging clinical examples. We may conclude that our manuscript may provide useful information for physicians on EEF application in clinical practice.

Highlights

A catheter-based treatment of patients with paravalvular leaks (PVL) has proven to be a safe and effective treatment option [1]
Widespread catheter-based interventions for structural heart disease have overtaken the treatment of paravalvular leaks (PVL)
With the experience gained and the appearance of devices dedicated for PVL treatment, the procedural success of the catheter-based PVL closure was enhanced [2,3]

Summary

Introduction

A catheter-based treatment of patients with PVL has proven to be a safe and effective treatment option [1]. Transoesophageal echocardiography (TEE) is an irreplaceable tool in diagnosing and procedural guidance in structural heart diseases. It delivers an accurate evaluation of the anatomical structures, physiologic performance of the heart and assesses the results of catheter-based procedures [4]. Interventional procedures for structural heart disease cannot be performed effectively without the information provided by fluoroscopy due to its superior visualization of catheters and implantable devices [5]. EFF images have given medical professionals the ability to observe synthesized visualization of the devices, tools, and soft tissue of intracardiac structures on one screen and in the same picture [6–8].

Methods

Discussion

Conclusion