title: Echogenic mobile images in intraprocedural three-dimensional transesophageal echocardiographic monitoring during percutaneous aortic valve implantation: Incidence, characteristics and clinical implications.
abstract: OBJECTIVE
  To investigate the incidence and clinical relevance of the presence of mobile echogenic images (MEI) during transesophageal echocardiography (TEE) for monitoring of transcatheter aortic valve implantation (TAVI).
  
  
  METHODS
  Consecutive patients referred to our center for transfemoral or transapical TAVI were included. The procedure was monitored by three-dimensional (3D) TEE and images were analyzed by two independent experts. In-hospital follow-up was carried out and correlated with imaging findings.
  
  
  RESULTS
  A total of 104 patients were included. MEI were visualized in 11 patients during the procedure (11%) and in over 50% of cases were identified as thrombi, however no differences in periprocedural stroke were found in follow-up.
  
  
  CONCLUSIONS
  Visualization of MEI during 3D TEE monitoring of TAVI is relatively common (11%) and in over 50% of cases they are identified as thrombi. The clinical implications of this finding are uncertain, as despite their frequency, the incidence of clinical stroke in this patient population was no higher. 3D TEE is a useful tool for diagnosis of MEI and can alert the operator to their presence.
authors.affiliation: Hospital La Paz, Madrid, Spain. Electronic address: earroyoucar@gmail.com.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Arroyo-Úcar
authors.affiliation: Hospital La Paz, Madrid, Spain.
authors.forename: Raúl
authors.initials: R
authors.lastname: Moreno
authors.affiliation: Hospital La Paz, Madrid, Spain.
authors.forename: Susana
authors.initials: S
authors.lastname: Del Prado
authors.affiliation: Hospital La Paz, Madrid, Spain.
authors.forename: Teresa
authors.initials: T
authors.lastname: López
authors.affiliation: Hospital La Paz, Madrid, Spain.
authors.forename: Angel
authors.initials: A
authors.lastname: Sánchez-Recalde
authors.affiliation: Hospital La Paz, Madrid, Spain.
authors.forename: Luis
authors.initials: L
authors.lastname: Calvo Orbe
authors.affiliation: Hospital La Paz, Madrid, Spain.
authors.forename: Santiago
authors.initials: S
authors.lastname: Jiménez-Valero
authors.affiliation: Hospital La Paz, Madrid, Spain.
authors.forename: Guillermo
authors.initials: G
authors.lastname: Galeote
authors.affiliation: Hospital La Paz, Madrid, Spain.
authors.forename: M Ulises
authors.initials: MU
authors.lastname: Ramírez
authors.affiliation: Hospital Infanta Cristina, Parla Madrid, Madrid, Spain.
authors.forename: Rosa
authors.initials: R
authors.lastname: Gonzalez Davia
authors.affiliation: Hospital Infanta Sofía, San Sebastián de los Reyes, Madrid, Spain.
authors.forename: Ignacio
authors.initials: I
authors.lastname: Plaza
authors.affiliation: Hospital La Paz, Madrid, Spain.
authors.forename: José María
authors.initials: JM
authors.lastname: Mesa
authors.affiliation: Hospital La Paz, Madrid, Spain.
authors.forename: Jose Luis
authors.initials: JL
authors.lastname: López-Sendón
mesh_terms: D001021:Aortic Valve / Q000601:surgery; D001024:Aortic Valve Stenosis / Q000175:diagnosis* / Q000601:surgery; D017548:Echocardiography, Transesophageal; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D021621:Imaging, Three-Dimensional; D015994:Incidence
keywords: 3 D; Aortic stenosis; Estenose aórtica; Implantação valvular aórtica percutânea; Three-dimensional; Transaortic valve; Transcatheter aortic valve implantation; Válvula transaórtica