title: Integrated x-ray and echocardiography imaging for structural heart interventions.
abstract: Treatment of structural heart disease (SHD) represents a growing need and, with increasing device availability, an increasing number of SHD can be and will be treated percutaneously. However, interventional treatment of SHD is challenging. Long procedure times and steep learning curves are recognised obstacles. The main difficulties arise, however, from the inability to visualise simultaneously the anatomy and the devices using a single imaging technology. In fact, the majority of percutaneous interventions in SHD are guided by fluoroscopy. On the other hand, a multitude of imaging technologies are presently available to guide the interventionalist. Of these technologies, transoesophageal echocardiography (TEE), and particularly 3-D TEE, is rapidly becoming the imaging modality of choice for many of these procedures because it provides critical insights into soft tissue anatomy. However, adequate visualisation and appreciation of the relationships between the cardiac structures and the devices using various imaging modalities remain a challenge. Hence, the interaction between the operator and imager is a crucial factor in attaining procedural success. Innovative technology that fuses live 3-D TEE with live x-ray in an intuitive way could have an important added value. This new imaging technology seeks to improve the communication between the echocardiographer and the interventionalist, to increase the confidence and anatomical awareness, to assist in guidance, and to increase procedural efficiency.
authors.affiliation: HeartClinic Hirslanden, Klinik Hirslanden, Zurich, Switzerland.
authors.forename: Roberto
authors.initials: R
authors.lastname: Corti
authors.forename: Patric
authors.initials: P
authors.lastname: Biaggi
authors.forename: Oliver
authors.initials: O
authors.lastname: Gaemperli
authors.forename: Ines
authors.initials: I
authors.lastname: Bühler
authors.forename: Christian
authors.initials: C
authors.lastname: Felix
authors.forename: Dominique
authors.initials: D
authors.lastname: Bettex
authors.forename: Oliver
authors.initials: O
authors.lastname: Kretschmar
authors.forename: Volkmar
authors.initials: V
authors.lastname: Falk
authors.forename: Jürg
authors.initials: J
authors.lastname: Grünenfelder
mesh_terms: D006328:Cardiac Catheterization; D006348:Cardiac Surgical Procedures; D004452:Echocardiography; D019560:Echocardiography, Three-Dimensional; D017548:Echocardiography, Transesophageal; D006331:Heart Diseases; D006801:Humans; D014965:X-Rays