The role of echocardiography in the development of Percutaneous Aortic / Mitral Valve technology – 3D Echocardiography (pp. 9-24)
Authors: (Leonardo Rodriguez)
Abstract: Traditionally echocardiography has played a predominant role in the evaluation of valvular heart disease. This technology has multiples advantages:
-Real time imaging with good temporal and spatial resolution
-Ability to assess anatomy and function.
Transthoracic echocardiography is usually enough for clinical management, however, in selected cases transesophageal echo offers superior image quality and is particularly useful in the evaluation of the mitral valve.
With the development of new percutaneous treatments for valvular heart disease, an expanded role of echocardiography has ensued [1-6]. Greater anatomic precision and better understanding of the pathophysiology of the lesions are now required. Similar to what occurred in the operative room, echocardiography has become an important tool in guiding procedures in the catheterization laboratory, assessing immediate post procedural results and diagnosis of complications.
The primary example of the preeminent role of echocardiography during percutaneous valvular procedures is the Eclip mitral valve repair [4, 5, 7, 8].
The availability of real time 3D echocardiography has increased our diagnostic capabilities and has added an important dimension in the detailed evaluation of the mitral valve [9-13].
The current 3D ultrasound equipment uses matrix-array technology with 2500 elements. It is now possible to acquire real time 3D rendered images as well as simultaneous biplane or multiplane 2D images.
Miniaturization has allowed this technology to be adapted for transesophageal probes and is now possible the recording of high spatial resolution images.
3D rendered images can be acquired in real time with the ability of choosing an area of interested and manipulate its orientation in real time. It can also be acquired as full volume over several beats for off-line analysis.
For procedural real time guidance the biplane and the real time 3D sector focused are the most utilized.