Novel uses of intracardiac echocardiography with a phased-array imaging catheter

Sheikh, Imran; Kumar, Deepak; Liu, Zheng; Kantharia, Bharat K.; MacMillan, Robert M.; Fyfe, Billie; Narula, Jagat; Vannan, Mani A.

doi:10.1016/s0894-7317(03)00474-7

Cited by 10 publications

(4 citation statements)

References 15 publications

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“…Intracardiac echocardiography (ICE) is capable of forming high quality ultrasound images of the heart from multiple angles [1]- [3]. Previous studies have evaluated the utility and advantages of intracardiac probes in cardiac imaging over transesophageal echocardiography [4]- [9] and fluoroscopic imaging [3], [10], [11]. In addition, several groups have demonstrated the effectiveness of intracardiac probes in the guidance of cardiac interventional procedures including: atrial septal defect closure [5], stent implantation [12], and mitral valvuloplasty [8].…”

Section: Introductionmentioning

confidence: 99%

Challenges and implementation of radiation-force imaging with an intracardiac ultrasound transducer

Hsu

Fahey

Dumont

et al. 2007

IEEE Trans. Ultrason., Ferroelect., Freq. Contr.

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Intracardiac echocardiography (ICE) has been demonstrated to be an effective imaging modality for the guidance of several cardiac procedures, including radiofrequency ablation (RFA). However, assessing lesion size during the ablation with conventional ultrasound has been limited, as the associated changes within the B-mode images often are subtle. Acoustic radiation force impulse (ARFI) imaging is a promising modality to monitor RFAs as it is capable of visualizing variations in local stiffnesses within the myocardium. We demonstrate ARFI imaging with an intracardiac probe that creates higher quality images of the developing lesion. We evaluated the performance of an ICE probe with ARFI imaging in monitoring RFAs. The intracardiac probe was used to create high contrast, high resolution ARFI images of a tissue-mimicking phantom containing stiffer spherical inclusions. The probe also was used to examine an excised segment of an ovine right ventricle with a RFA-created surface lesion. Although the lesion was not visible in conventional B-mode images, the ARFI images were able to show the boundaries between the lesion and the surrounding tissue. ARFI imaging with an intracardiac probe then was used to monitor cardiac ablations in vivo. RFAs were performed within the right atrium of an ovine heart, and B-mode and ARFI imaging with the intracardiac probe was used to monitor the developing lesions. Although there was little indication of a developing lesion within the B-mode images, the corresponding ARFI images displayed regions around the ablation site that displaced less.

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Section: Introductionmentioning

confidence: 99%

Challenges and implementation of radiation-force imaging with an intracardiac ultrasound transducer

Hsu

Fahey

Dumont

et al. 2007

IEEE Trans. Ultrason., Ferroelect., Freq. Contr.

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“…Adult case reports include the use of ICE to guide balloon mitral valvuloplasty [7,38] and valvuloplasty of a stenotic prosthetic tricuspid valve [10]. While not technically congenital defects, ICE has been used to guide closure of post-infarct ventricular septal defects and directed biopsy of intracardiac masses [7,39,41].…”

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confidence: 99%

Intracardiac Echocardiography in Congenital Heart Disease

Barker

2009

J. of Cardiovasc. Trans. Res.

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The use of intracardiac echocardiography (ICE) in congenital heart disease has become well established over the past 7 years since its introduction into clinical imaging. The greatest experience has been to guide percutaneous device closures of secundum atrial septal defects and patent foramen ovale, with excellent safety and clinical results. However, ICE has also been used for the evaluation and management of many other congenital heart defects given its unique blood/transducer interface and close proximity to relevant cardiac anatomy. Clinical application of ICE is expanding, with the current ICE catheters being used as micro-transesophageal echo probes, and three-dimensional prototypes already developed and tested in animal models. It is expected that ICE will further increase in use with refinements in technology and greater operator experience, aiding the management of complex congenital heart disease.

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“…The detection of these complications permits early therapeutic decisions. Also other procedures [10], such as percutaneous mitral valvuloplasty [11] can potential being guided by ICE.…”

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confidence: 99%

Intracardiac echocardiography. A new tool in the cath lab

Bouma

Mulder

2005

Int J Cardiovasc Imaging

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In response to the article by Zanchetta et al. (Int. J. Cardiovasc. Imaging 21,[391][392][393][394][395][396][397][398][399][400][401] In this volume, Zanchetta et al. [1] validate intracardiac echocardiography (ICE) by correlating the ICE images with anatomic sections and magnetic resonance scan planes.Interventional cardiac procedures, as for electrophysiology and interventions in congenital heart disease, have always been performed under fluoroscopic guidance and/or transesophageal echocardiography. Fluroscopy only produces global representation of the heart, necessitates an experienced skills level of the physician. Transesophageal echocardiography requires the presence of an ultrasound physician and an anesthesiologist to assist in procedures such as closure of atrial septum defects, patent foramen ovale, and more. These procedures can gain benefit by reducing Xray time, eliminating heavy sedation and discomfort and aspiration risk associated with transesophageal echocardiography and by simplifying the procedure into a single-operator action. The need for a feasible and accurate alternative imaging modality was obvious.Current intracardiac echocardiography catheters are flexible by its ability to move in four directions (anterior-posterior, and left-right position) up to 160°. They can be connected to standard and laptop size ultrasound machines. The high resolution images reveal critical information about cardiac anatomy, great vessels, blood flow direction and velocity, and the position of devices. This rapidly makes the ultrasound catheter a standard tool in many interventional procedures [2].The clinical application of intracardiac echocardiography started some years ago. In the electrophysiology, the use of ICE generates with its excellent visualization of the fossa ovalis, better imaging modality than fluoroscopy in the guidance of trans-septal punctures, especially in less experienced hands [3]. It is useful in the positioning and stabilization of the imaging ablation catheter, the evaluation of the lesion size and continuity and in the immediate identification of complications. Furthermore it improves the long-term outcome in pulmonary vein isolation with its direct visualization of microbubble formation and thereby reducing the risk of pulmonary vein stenosis [4].In congenital heart disease, ICE can be used for diagnostic purposes because of its superior image quality as compared to similar views with transesopageal echocardiography [5]. Interventions in congenital heart disease use already extendedly ICE. Especially, in the percutaneous closure of atrial septal defects, the combination with ICE allows quantitative and qualitative information for both proper ASO selection and optimal device placement [6,7]. It is associated with shorter laboratory and interventional procedure time as compared with trans-esopageal guided procedures [8]. ICE is of help in visualizing clinical complications that might occur in some procedures such as pericardial effusion, clot detection, and therapeutic device misposit...

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Novel uses of intracardiac echocardiography with a phased-array imaging catheter

Cited by 10 publications

References 15 publications

Challenges and implementation of radiation-force imaging with an intracardiac ultrasound transducer

Challenges and implementation of radiation-force imaging with an intracardiac ultrasound transducer

Intracardiac Echocardiography in Congenital Heart Disease

Intracardiac echocardiography. A new tool in the cath lab

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