Catheter-based interventions guided solely by a new phased-array intracardiac imaging catheter: in vivo experimental studies.
BACKGROUND
Intracardiac echocardiography (ICE) has had useful but limited use during interventional procedures because of technologic limitations. We used a novel phased-array ICE device (AcuNav) with 2-dimensional sector imaging and full Doppler capability to see whether it could guide cardiac interventions without fluoroscopy.


METHODS
Twelve dogs were studied, and we performed atrial septostomy, tricuspid, and pulmonary valve disruption using only ICE. Preinterventional and postinterventional anatomic and hemodynamic data were noted.


RESULTS
All attempts were successful in the placement of the ICE catheter (100%). We attempted septostomy on 11 dogs and were successful 8 times (73%). Tricuspid valve disruption and balloon dilatation were performed successfully on 5 dogs (100%). We attempted pulmonary valve disruption on 4 dogs and could always correctly place the guidewire (100%). We performed pulmonary valve balloon dilatation on one dog (25%). A comprehensive echocardiographic examination was always possible.


CONCLUSIONS
This new ICE device can guide interventions without fluoroscopy. However, further studies are needed to evaluate whether it can replace fluoroscopy.
Dairywala
Ismail T
IT
Division of Cardiology, Department of Internal Medicine, University of Michigan Health System, Ann Arbor, MI, USA.
Li
Peng
P
Liu
Zheng
Z
Bowie
Dana
D
Stewart
Scott R
SR
Bayoumy
Abdel-Azim
AA
Murthy
Thippeswamy H
TH
Vannan
Mani A
MA
D000818:Animals; D006328:Cardiac Catheterization / Q000295:instrumentation*; D002404:Catheterization / Q000379:methods; D004285:Dogs; D004452:Echocardiography; D005240:Feasibility Studies; D006325:Heart Atria / Q000000981:diagnostic imaging*; D006346:Heart Septum / Q000000981:diagnostic imaging; D008943:Mitral Valve / Q000000981:diagnostic imaging; D011664:Pulmonary Valve / Q000000981:diagnostic imaging*; D014159:Transducers; D014261:Tricuspid Valve / Q000000981:diagnostic imaging*; D018084:Ultrasonography, Interventional / Q000295:instrumentation* / Q000379:methods