Ο ΡΟΛΟΣ ΤΗΣ ΥΠΕΡΗΧΟΚΑΡΔΙΟΓΡΑΦΙΑΣ ΣΤΟ … · real-time 3-dimensional...
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Ο ΡΟΛΟΣ ΤΗΣ ΥΠΕΡΗΧΟΚΑΡΔΙΟΓΡΑΦΙΑΣ ΣΤΟ ΑΙΜΟΔΥΝΑΜΙΚΟ ΕΡΓΑΣΤΗΡΙΟ
Κ. Αγγελη
Αναπλ. Καθηγητρια Καρδιολογιας
Α Πανεπ. Καρδιολογικη Κλινικη
Ιπποκρατειο Νοσοκομειο Αθηνας
• …..INTERVENTIONAL TEE IS USED TO GUIDE AND ASSESS THE PROGRESS
AND OUTCOME OF INTERVENTIONS IN A REAL-TIME, CONTINUOUS, AND
STEPWISE FASHION.
• IN THIS CONTEXT THE INTERVENTIONAL ECHOCARDIOGRAPHER BECOMES A
CO-PROCEDURALIST, PROVIDING CLEAR, TIME-EFFICIENT, STEP-BY-STEP
GUIDANCE FOR INTERVENTIONAL CARDIOLOGISTS NAVIGATING THE
COMPLEXITIES OF CARDIAC ANATOMY WITH CATHETERS, BALLOONS, AND
DEVICES. IT IS CRITICAL THAT DURING INTRA-PROCEDURAL IMAGING, THE
INTERVENTIONALIST AND ECHOCARDIOGRAPHER MAINTAIN CONSTANT
COMMUNICATION REGARDING ANATOMIC STRUCTURE AND FUNCTION AS
WELL AS THE ACTUAL PROGRESS OF THE PROCEDURE. …..
3D ECHO: A NEW DIMENSION TO ASSESS THE HEART
High spatial and temporal resolution—
which allows unique details views of
cardiac structures.
This additional information helps guide
interventional procedures leading
to safer and shorter procedures with higher
technical success,
decreased radiation exposure, and
improved patient outcomes
TRANSCATHETER INTERVENTIONS
TRANSTHORACIC OR TRANSESOPHAGEAL ECHO
• PERICARDIOPARACEDESIS (UNDER TTE GUIDANCE)
UNDER TEE GUIDANCE
• MITRAL VALVULOPLASTY IN VALVE STENOSIS
• ASD OR PATENT FORAMEN OVALE
• VSD
• AORTIC VALVE IMPLANTATION
• MITRAL CLIP IMPLANTATION IN VALVE REGURGITATION
• LEFT ATRIAL APPENDAGE CLOSURE FOR ATRIAL FIBRILLATION
• PARAVALVULAR LEAK
• PDA/ANEURYSM
• TRICUSPID – PULMONIC VALVE IMPLANTATION
• MITRAL VALVE IMPLANTATION
MITRAL STENOSIS-BALLOON VALVULOPLASTY
TRANSEPTAL PUNCTURE
MITRAL VALVE BALLOON VALVULOPLASTY
PERICARDIAL TAMPONADE
HEMODYNAMIC IMPROVEMENT
3D VARIOUS TYPES OF ASD
PRE DISK IMPLANTATION
AMPLATZER SYSTEM IMPLANTATION
ATRIAL SEPTAL DEFECT (S) CLOSURE
EDWARDS SAPIENS MEDRONIC COREVALVE
RIGHT ANNULAR-OSTIAL DISTANCE EDWARDS-SAPIENS
THREE-DIMENSIONAL 3D DATASETS CAN BE USED TO IMAGE THE AORTIC VALVE IN THE CORONAL PLANE AND MEASURE THE LEFT
ANNULAR-OSTIUM DISTANCE
MITRAL VALVE‘’CENTER OF THE VASCULAR
NETWORK’’
MITRAL VALVE‘’CENTER OF THE VASCULAR
NETWORK’’
REAL-TIME 3D TRANSESOPHAGEAL ECHOCARDIOGRAPHY IN MITRAL VALVE CLIPPING
MITRAL VALVE EVALUATION-2D/3D TEE
2D TEE DURING THE PROCEDURE
3D TEE DURING THE PROCEDURE
AFTER MITRAL CLIP DEPLOYMENT
SUCCESSFUL MITRAL CLIP DEPLOYMENT
PARAVALVULAR LEAK-3D DURING THE PROCEDURE
LEFT ATRIAL DEVICE APPENDAGE
• …IS A PROCEDURE RECOMMENDED TO REDUCE THE RISK OF EMBOLI
IN PATIENTS WHO ARE UNABLE TO RECEIVE ANTICOAGULANT
TREATMENT FOR ATRIAL FIBRILLATION.
• THE WATCHMAN LEFT ATRIAL APPENDAGE SYSTEM
• THE AMPLATZER CARDIAC PLUG III
THE WATCHMAN LEFT ATRIAL APPENDAGE SYSTEM
LEFT ATRIAL DEVICE APPENDAGE - AMPLATZER DEVICE
AORTIC ANEURYSM
BEFORE PLUG IMPLANTATION
AFTER IMPLANTATION
PDA
PRE DEVICE IMPLANTATION
AFTER DEVICE IMPLANTATION
TIARA VALVE TENDYNE VALVE
MEDRONIC MV
THE CAVOTRICUSPID ISTHMUS = A MUSCULAR REGION OF RA
NEW DEVICES NEW VALVES
REAL-TIME 3-DIMENSIONAL TRANSOESOPHAGEAL ECHOCARDIOGRAPHY; AN INDISPENSIBLE RESIDENT IN THE CATHETER LABORATORY
CONSTANTINA AGGELI, MICHAEL BELLAMY, NILESH SUTARIA, CHRISTODOULOSSTEFANADIS* AND PETROS NIHOYANNOPOULOS
EDITORIAL HELL J CARDIOL: JAN 2012
• RT 3D TOE IS A NOW A REGULAR RESIDENT AT THE CATHETER LABORATORY AS IT IS USED FOR
ALL SORTS OF INTERVENTIONS. THE INTERVENTIONAL ECHOCARDIOGRAPHER MUST BE AWARE
OF THE DIFFERENT IMPLANTATION PROCEDURES BEFORE ATTEMPTING TO GUIDE A PROCEDURE
AND BE APPROPRIATELY TRAINED IN A HIGH OUTPUT DEPARTMENT.
• RT 3D TOE HAS BEEN SHOWN TO PROVIDE ADDITIONAL INSIGHT IN THE ANATOMICAL,
MORPHOLOGICAL AND HAEMODYNAMIC STATEMENT. IT HAS BECOME THE IMAGING
MODALITY OF CHOICE BY MANY INTERVENTIONALISTS, AND IN MANY CASES IT SERVES AS
‘THE OPERATOR’S EYES’ TO EVALUATE, GUIDE, AND ASSESS THE RESULTS OF THE PROCEDURES
IN THE CATH LAB.
• THE UNIQUE STRUCTURAL INFO OBTAINED BY RT3D TOE OFFER SHORTER AND SAFER
INTERVENTIONAL PROCEDURES, WITH HIGHER TECHNICAL SUCCESS, THUS IMPROVING PATIENT
OUTCOMES.
INTERVENTIONAL CARDIOLOGY PROCEDURES FOR STRUCTURAL HEART
DISEASE….