New imaging modalities in the catheterization laboratory

Abstract

Knowledge and proper application of new imaging modalities during interventions in the catheterization laboratory may improve the outcomes of patients with congenital and acquired structural heart disease.

Intravascular Ultrasound Characterization of a Tissue-Engineered Vascular Graft in an Ovine Model

“…It is most frequently described in the adult population with placement of stents for the treatment of aneurysms or atherosclerosis [6–10]. The advantages of this technique are a limitation of contrast use, a 2-dimensional view of the vessel lumen, an ability to determine true from false lumens, and accurate assessment of stent apposition to the luminal wall [11–13].…”

“…Specifically, findings of medial hypertrophy and intimal hyperplasia have been correlated with increased pulmonary hypertension [22–25]. IVUS has also been used in a fashion similar to that in adults in examining the placement of intravascular stents [6,26]. These conditions share a commonality in that they all lead to vessel wall changes, suggesting that the use of IVUS in patients receiving TEVGs would allow surveillance of growth, remodeling, and the development of pathologic lesions within the walls of the evolving neovessel, which would surpass the capabilities of traditional angiographic imaging.…”

Role of Transesophageal Echocardiography in Transcatheter Occlusion of Atrial Septal Defects

“…Even though closure of PFO under the guidance of ICE is safe and effective, ICE may not be sensitive enough to detect all patients with right to left shunting. (Van et al 2010;Pedra, Fleishman et al 2011) In addition to this, limited field view for far field device complications, the need for a second venous sheath, the requirement for additional training, potential trigger of atrial arrhythmias are among the disadvantages of ICE. In the setting of a single operator, it may be a more challenge to manipulate the ICE catheter at the same time the closure device.…”

Plugging Holes

“…Several different methods to overlay 3D information from either transesophageal echocardiography or CT scan to fluoroscopic images have been used. 5,6 Three-dimensional transesophageal echocardiographic guidance for device manipulation is also critically important. Understanding of the anatomy and details of the devices is paramount to the success of these procedures, and the authors should be congratulated for their technical skills.…”