New imaging modalities in the catheterization laboratory.
OBJECTIVE
To provide an overview of the various modalities that have emerged in the last years as adjunctive tools to provide detailed imaging of the cardiovascular system in the catheterization laboratory.


RESULTS
Completion angiography after cardiac surgery for congenital heart disease using a dedicated hybrid operating cardiac suite may aid in early diagnosis and therapy of postsurgical abnormalities. The application of three-dimensional rotational digital angiography results in a more precise delineation of the three-dimensional anatomy of vascular structures outside the heart with rapid image processing and reduction of the amount of contrast used and ionizing radiation dose. Combined catheterization/magnetic resonance (MR) hybrid laboratories have the potential to accurately assess changes in the anatomy and physiology pretranscatheter and posttranscatheter interventions. Fully MR-guided transcatheter procedures have become possible in animal models. Real-time three-dimensional transesophageal echocardiography (TEE) has helped to guide transcatheter procedures in septal and valvar structures. Miniaturization of probes has expanded the applications of TEE for smaller neonates. The use of intravascular ultrasound has helped to better understand the mechanisms of vascular diseases and transcatheter treatments.


CONCLUSIONS
Knowledge and proper application of new imaging modalities during interventions in the catheterization laboratory may improve the outcomes of patients with congenital and acquired structural heart disease.
Catheterization Laboratory for Congenital Heart Disease, Instituto Dante Pazzanese, Avenida Dr Dante Pazzanese 500, Sao Paulo, Brazil. cacpedra@uol.com.br
Carlos A C
CA
Pedra
Craig
C
Fleishman
Simone F
SF
Pedra
John P
JP
Cheatham
D015901:Angiography, Digital Subtraction / Q000295:instrumentation / Q000379:methods; D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation / Q000379:methods; D006328:Cardiac Catheterization / Q000295:instrumentation* / Q000379:methods; D003199:Computer Systems; D003952:Diagnostic Imaging / Q000295:instrumentation / Q000379:methods; D017548:Echocardiography, Transesophageal / Q000295:instrumentation / Q000379:methods; D006330:Heart Defects, Congenital / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000628:therapy; D006801:Humans; D007753:Laboratories; D008279:Magnetic Resonance Imaging / Q000295:instrumentation / Q000379:methods; D018084:Ultrasonography, Interventional