Intracardiac echocardiographic imaging with a cartosound module for guidance of left atrial appendage closure: a comparative study with transesophageal echocardiographic imaging.
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引用次数: 0
Abstract
Purpose: In most clinical trials, intracardiac echocardiography (ICE) has provided fewer views than the four standard views provided by transesophageal echocardiography (TEE) when assessing left atrial appendage closure (LAAC) devices. This study aimed to determine if ICE guided by the CartoSound system achieve adequate high-quality views and similar clinical outcomes as TEE during LAAC.
Methods: This study prospectively enrolled 202 patients who underwent LAAC using either ICE (n = 69), TEE (n = 121), or a combination of ICE and TEE (n = 12) as the procedural imaging under local anesthesia. A novel multi-angled "FLAVOR" approach was used for assessment in the ICE group.
Results: ICE allowed visualization of the implanted devices in all patients at all proposed angles with long-axis views while two-dimensional (2D) TEE showed short-axis views in 1 or 2 angles in 24.2% of cases, which was more prevalent when the pulmonary ridge was covered by the occluder. In the combined ICE-TEE cohort, 2D-TEE failed to detect peri-device leak in 1 patient. The complication rates were similar between the ICE and TEE groups. Shorter fluoroscopy time, lower radiation dose and contrast usage were founded in the ICE group. At first TEE follow-up, the rate and degree of peri-device leak were similar between the ICE and TEE groups.
Conclusion: A systematic ICE protocol using a CartoSound module to guide LAAC was reliable for comprehensive long-axis imaging assessment compared with 2D/3D TEE under local anesthesia with a shorter fluoroscopy time, lower radiation dose, and less use of contrast.
期刊介绍：
The International Journal of Cardiovascular Imaging publishes technical and clinical communications (original articles, review articles and editorial comments) associated with cardiovascular diseases. The technical communications include the research, development and evaluation of novel imaging methods in the various imaging domains. These domains include magnetic resonance imaging, computed tomography, X-ray imaging, intravascular imaging, and applications in nuclear cardiology and echocardiography, and any combination of these techniques. Of particular interest are topics in medical image processing and image-guided interventions. Clinical applications of such imaging techniques include improved diagnostic approaches, treatment , prognosis and follow-up of cardiovascular patients. Topics include: multi-center or larger individual studies dealing with risk stratification and imaging utilization, applications for better characterization of cardiovascular diseases, and assessment of the efficacy of new drugs and interventional devices.
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