title: Echocardiographic and Fluoroscopic Fusion Imaging for Procedural Guidance: An Overview and Early Clinical Experience.
abstract: There has been significant growth in the volume and complexity of percutaneous structural heart procedures in the past decade. Increasing procedural complexity and accompanying reliance on multimodality imaging have fueled the development of fusion imaging to facilitate procedural guidance. The first clinically available system capable of echocardiographic and fluoroscopic fusion for real-time guidance of structural heart procedures was approved by the US Food and Drug Administration in 2012. Echocardiographic-fluoroscopic fusion imaging combines the precise catheter and device visualization of fluoroscopy with the soft tissue anatomy and color flow Doppler information afforded by echocardiography in a single image. This allows the interventionalist to perform precise catheter manipulations under fluoroscopy guidance while visualizing critical tissue anatomy provided by echocardiography. However, there are few data available addressing this technology's strengths and limitations in routine clinical practice. The authors provide a critical review of currently available echocardiographic-fluoroscopic fusion imaging for guidance of structural heart interventions to highlight its strengths, limitations, and potential clinical applications and to guide further research into value of this emerging technology.
authors.affiliation: Division of Cardiovascular Disease, Mayo Clinic, Rochester, Minnesota. Electronic address: thaden.jeremy@mayo.edu.
authors.forename: Jeremy J
authors.initials: JJ
authors.lastname: Thaden
authors.affiliation: Division of Cardiovascular Disease, Mayo Clinic, Rochester, Minnesota.
authors.forename: Saurabh
authors.initials: S
authors.lastname: Sanon
authors.affiliation: Division of Cardiovascular Disease, Mayo Clinic, Rochester, Minnesota.
authors.forename: Jeffrey B
authors.initials: JB
authors.lastname: Geske
authors.affiliation: Division of Cardiovascular Disease, Mayo Clinic, Rochester, Minnesota.
authors.forename: Mackram F
authors.initials: MF
authors.lastname: Eleid
authors.affiliation: Philips Healthcare, Best, The Netherlands.
authors.forename: Niels
authors.initials: N
authors.lastname: Nijhof
authors.affiliation: Division of Cardiovascular Disease, Mayo Clinic, Rochester, Minnesota.
authors.forename: Joseph F
authors.initials: JF
authors.lastname: Malouf
authors.affiliation: Division of Cardiovascular Disease, Mayo Clinic, Rochester, Minnesota.
authors.forename: Charanjit S
authors.initials: CS
authors.lastname: Rihal
authors.affiliation: Division of Cardiovascular Disease, Mayo Clinic, Rochester, Minnesota.
authors.forename: Charles J
authors.initials: CJ
authors.lastname: Bruce
mesh_terms: D006328:Cardiac Catheterization / Q000379:methods*; D004452:Echocardiography / Q000379:methods*; D019317:Evidence-Based Medicine; D005471:Fluoroscopy / Q000379:methods*; D006331:Heart Diseases / Q000175:diagnosis* / Q000628:therapy*; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D064847:Multimodal Imaging / Q000379:methods*; D015641:Radiography, Interventional / Q000379:methods; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D018084:Ultrasonography, Interventional / Q000379:methods
keywords: Fluoroscopy; Fusion imaging; Structural heart disease; Transesophageal echocardiography