3D TEE During Catheter-Based Interventions

Abstract

Guidance of catheter-based procedures is performed using fluoroscopy and 2-dimensional transesophageal echocardiography (TEE). Both of these imaging modalities have significant limitations. Because of its 3-dimensional (3D) nature, 3D TEE allows visualizing the entire scenario in which catheter-based procedures take place (including long segments of catheters, tips, and the devices) in a single 3D view. Despite these undeniable advantages, 3D TEE has not yet gained wide acceptance among most interventional cardiologists and echocardiographists. One reason for this reluctance is probably the absence of standardized approaches for obtaining 3D perspectives that provide the most comprehensive information for any single step of any specific procedure. Therefore, the purpose of this review is to describe what we believe to be the most useful 3D perspectives in the following catheter-based percutaneous interventions: transseptal puncture; patent foramen ovale/atrial septal defect closure; left atrial appendage occlusion; mitral valve repair; and closure of paravalvular leaks.

Two-dimensional versus three-dimensional transesophageal echocardiography in percutaneous left atrial appendage occlusion

“…Moreover, RT3D TEE enables better imaging of the structures surrounding the LAA, thus reducing the probability of malposition. Use of RT3D TEE instead of RT2D TEE also generates practical advantages, such as avoiding potential complications, reducing radiation exposure, and/or shortening procedural times [23]. A possible limitation of RT3D TEE may be the lack of standards for obtaining RT3D TEE images.…”

Ecocardiografía avanzada: aplicación clínica actual del análisis de deformación miocárdica y de la imagen tridimensional

“…Existen documentos de revisión (Faletra et al 2014) que resumen la utilidad de la imagen 3D para cada intervención (Figura 10).…”

Update on Cardiac Imaging Techniques 2014

“…16 In patients with severe aortic stenosis undergoing percutaneous device implantation, preprocedure measurement of the aortic annulus by a new 3D echocardiography method provides results similar to those obtained by cardiac computed tomography (CT) study and predicts the development of paravalvular regurgitation with similar precision. 17 Two excellent reviews by Faletra et al 18,19 have described the contribution of echocardiography in general and the 3D technique in particular before and during MitraClip implantation. It may also be possible to introduce the use of 3D-TEE in other settings, such as pulmonary vein ablation.…”