J Cardiovasc Imaging.  2019 Jul;27(3):227-229. 10.4250/jcvi.2019.27.e30.

Three-dimensional EchoNavigator System Guided Transcatheter Closure of Paravalvular Leakage

• Kim BH
• Koh YS
• Lee KY
• Chung WB

• KMID: 2456859
• DOI: http://doi.org/10.4250/jcvi.2019.27.e30

Abstract

No abstract available.

MeSH Terms

Heart Valve Prosthesis
Aged
Humans
Female
Mitral Valve Insufficiency
Cardiac Catheterization
Heart Valve Diseases
Erythrocyte Transfusion
Echocardiography, Three-Dimensional
Echocardiography, Transesophageal

Figure

• 

  Figure 1 Pre-procedural transesophageal echocardiography (TEE). (A) Two-dimensional TEE color Doppler image demonstrated severe paravalvular leakage (yellow arrow). (B) Three-dimensional TEE image demonstrated dark holes between the prosthetic mitral valve and mitral annulus (white arrows), which was localized at the medial side of the anterior mitral annulus, near to the aortic valve. AV: aortic valve, LA: left atrium, LAA: left atrial appendage, LV: left ventricle.

• 

  Figure 2 Fusion image from the EchoNavigator System (Phillips Healthcare, Best, The Netherlands) during the procedure. Green dot, demonstrated on fluoroscopic view (A), was marked from the real-time 3-dimenstion transesophageal echocardiography image (B). The guide wire was targeted to the green dot on fluoroscopic view and was successfully passed through the slit.

• 

  Figure 3 Fusion image from EchoNavigator System (Phillips Healthcare, Best, The Netherlands) after deployment. (A) Final positions of two Amplatzer™ vascular plugs are shown by fluoroscopy. (B) Color Doppler image demonstrated markedly reduced paravalvular leakage (white arrow) compared to Figure 1A. (C) Three-dimensional transesophageal echocardiography demonstrated final position of the vascular plugs (white circle).

Reference

1. Cruz-Gonzalez I, Rama-Merchan JC, Rodríguez-Collado J, et al. Transcatheter closure of paravalvular leaks: state of the art. Neth Heart J. 2017; 25:116–124.

2. Hascoet S, Smolka G, Bagate F, et al. Multimodality imaging guidance for percutaneous paravalvular leak closure: Insights from the multi-centre FFPP register. Arch Cardiovasc Dis. 2018; 111:421–431.