Photo-Realistic Echocardiography Imaging During Percutaneous Paravalvular Leak Closure

Barreiro-Pérez, Manuel; Cruz-González, Ignacio; Gil-Ortega, Manuel Villa; Rasco, Agustín Guisado; Sánchez, Pedro L.

doi:10.1016/j.jcin.2020.08.031

Cited by 5 publications

(7 citation statements)

References 2 publications

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“…Both qualitative and quantitative evaluations of functional and degenerative MV disease have been substantially improved by 3D echocardiography [ 18 , 19 , 20 , 21 , 22 ]. Recently 3DTTE and 3DTEE diagnostic accuracy has been further improved thanks to new transducers, software and transillumination techniques [ 7 , 9 , 10 , 11 , 12 , 13 , 14 ]. Transillumination is user friendly: a touch screen allows operator to change the light source orientation, creating a 3D reconstruction that markedly emphasize a shadow effect.…”

Section: Discussionmentioning

confidence: 99%

“…Recently a new 3D rendering tool known as transillumination (3DTr), which integrates a virtual light source into the data set, and transparency or “glass” effect (3DGl) that allow the operator to adjust the degree of cardiac and extracardiac structure transparency further improved visualization and delineation of anatomy and pathology and improved localization of regurgitant jets compared with the standard 3D rendering (3DSt) [ 9 , 10 , 11 , 12 ]. It has been hypothesized in very preliminary reports that the addition of this new tissue 3DTr tool and its integration with 3D color Doppler would result in improved anatomic detail, border definition and localization of pathology, including regurgitant jet origin, compared with 3DSt rendering both with and without 3DTr [ 13 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

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Head to Head Comparison between Different 3-Dimensional Echocardiographic Rendering Tools in the Imaging of Percutaneous Edge-to-Edge Mitral Valve Repair

Tamborini

Mantegazza

Garlaschè

et al. 2021

JCDD

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MitraClip (MC) is the most common percutaneous treatment for severe mitral regurgitation (MR). An accurate two-dimensional and three-dimensional echocardiographic (3DTEE) imaging is mandatory for the optimal procedural result. Recently transillumination 3DTEE rendering (3DTr) has been introduced integrating a virtual light source into the dataset and with the addition of glass effect (3DGl) allows to adjust tissue transparency improving depth perception and anatomical structure delineation in comparison with the standard 3DTEE (3DSt). The aim of this retrospective study in 30 patients undergoing MC, was to compare 3DSt, 3DTr, and 3DGl in mitral valve (MV) evaluation and procedural result assessment. 3DTEE acquisitions obtained before and after MC were processed with 3DSt, 3DTr, and 3DGl rendering. Each reconstruction was scored for quality and for ability to recognize MV anatomy, MR origin, clip position, dimension and grasping. Imaging quality was judged good or optimal in 52%, 76%, and 96% in 3DSt, 3DTr, and 3DGl reconstructions respectively. In 26/30 patients a diagnostic incremental value was found with 3DTr vs. 3DSt and in 15/26 with 3DGl vs. 3DTr and 3DSt. Only 3DGl with perpendicular cropping of the clip allowed to visualize and measure the grasped portion of each mitral leaflets. 3DTEE imaging during MC may be improved by 3DTr and 3DGl providing a better evaluation of MV, of leaflet grasping and of residual MR jets after MC.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Head to Head Comparison between Different 3-Dimensional Echocardiographic Rendering Tools in the Imaging of Percutaneous Edge-to-Edge Mitral Valve Repair

Tamborini

Mantegazza

Garlaschè

et al. 2021

JCDD

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“…6 Em casos selecionados, para evitar riscos da ecocardiografia transesofágica e a anestesia associada, o uso da ecocardiografia intracardíaca pode ser uma alternativa, embora tenha limitações técnicas frente aos aparelhos de ecocardiografia transesofágica quanto a definição espacial e ainda seja indisponível na maioria dos serviços nacionais. 6,10,12,13 Os dispositivos de fechamento são escolhidos de 2 a 3 mm maiores do que o diâmetro aferido. Uma vez que…”

Section: Planejamento E Intraoperatóriounclassified

Como Eu Faço Abordagem para Avaliação de Leak Paraprotético Mitral

Bignoto

2024

Arq Bras Cardiol: Imagem cardiovasc.

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O leak paraprotético mitral é uma condição comum, embora seja frequentemente assintomática. Quando apresenta manifestações clínicas, como insuficiência cardíaca e/ou hemólise, o tratamento intervencionista está indicado. Recentemente, a abordagem transcateter ganhou destaque e, para isso, é necessária uma avaliação por métodos de imagem no planejamento. A ecocardiografia é o método mais utilizado e as informações a serem verificadas e confirmadas são gravidade, localização, tamanho, forma e o número de vazamentos (leaks). Uma vez definidas essas variáveis, o planejamento de abordagem é realizado, sendo a via transeptal a mais utilizada. A decisão do melhor lugar de punção septal depende de vários fatores, mas a localização precisa do pertuito é o mais importante. Uma vez realizado o posicionamento dos dispositivos, a avaliação ecocardiográfica intraoperatória determina o sucesso do procedimento e orienta necessidades de reposicionamento e ajustes, bem como sinaliza eventuais complicações que possam ocorrer.

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“…Indeed, 3D-TEE is the recommended technique to guide percutaneous PVL closure procedures (especially in mitral location), as well as playing an important role in selection of the most appropriate closure device [ 8 , 11 , 13 , 14 ]. Recently, photorealistic rendering views (True- Vue, Philips Healthcare, Best, Netherlands) have been developed to increase 3D perception, making it possible to change the lighting source to improve contrast and enhance details, which would make it easier to identify defects [ 15 , 16 ] ( Figure 3 ).…”

Section: Diagnosismentioning

confidence: 99%

Mitral Paravalvular Leak: Clinical Implications, Diagnosis and Management

Cruz-González

Antúnez-Muiños

López-Tejero

et al. 2022

JCM

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Paravalvular leak incidence after mitral surgical replacement ranges from 7% to 17%. Between 1% and 5% of these are clinically significant. Large PVLs can cause important clinical manifestations such as heart failure or haemolysis. Current guidelines consider that surgical reparation is the gold-standard therapy in symptomatic patients with paravalvular leak. However, these recommendations are based in non-randomized observational registries. On the other hand, transcatheter paravalvular leak closure has shown excellent results with a low rate of complications, and nowadays it is considered the first option in selected patients in some experienced centres. In this review, we summarize the clinical manifestations, diagnosis, procedural details, and results of transcatheter mitral PVL closure.

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Photo-Realistic Echocardiography Imaging During Percutaneous Paravalvular Leak Closure

Cited by 5 publications

References 2 publications

Head to Head Comparison between Different 3-Dimensional Echocardiographic Rendering Tools in the Imaging of Percutaneous Edge-to-Edge Mitral Valve Repair

Head to Head Comparison between Different 3-Dimensional Echocardiographic Rendering Tools in the Imaging of Percutaneous Edge-to-Edge Mitral Valve Repair

Como Eu Faço Abordagem para Avaliação de Leak Paraprotético Mitral

Mitral Paravalvular Leak: Clinical Implications, Diagnosis and Management

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