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Published in: Current Cardiovascular Imaging Reports 6/2012

01-12-2012 | Echocardiography (MH Picard, Section Editor)

Role of Echocardiography to Guide New Transcatheter Interventions for Valvular Heart Disease

Authors: Sofia Shames, Linda D. Gillam

Published in: Current Cardiovascular Imaging Reports | Issue 6/2012

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Abstract

New devices for transcatheter aortic valve implantation, mitral repair, and closure of prosthetic paravalvular leaks have expanded the options for catheter-based approaches to patients with regurgitant as well as stenotic valvular disease. Echocardiography (2-dimensional and 3-dimensional) plays an important role in identifying patients suitable for these interventions, helps provide peri-procedural monitoring, and is essential for post-procedure follow-up. The optimal use of echocardiography requires an understanding of the structure and method of implantation of available devices, the anatomic and functional patient selection criteria, and imaging characteristics of implanted devices, particularly those that differ from devices used in traditional surgical interventions. This document describes the role of echocardiography in the most commonly performed transcatheter interventions for valvular heart disease: transcatheter aortic valve implantation, MitraClip mitral valve repair, and transcatheter perivalvular leak closure.
Literature
1.
go back to reference • Zamorano JL, Badano LP, Bruce C, et al. EAE/ASE recommendations for the use of echocardiography in new transcatheter interventions for valvular heart disease. J Am Soc Echocardiogr. 2011;24:937–65. This document provides a detailed description of the use of 2-D and 3D echcoardiography in transcatheter valvular interventions.PubMedCrossRef • Zamorano JL, Badano LP, Bruce C, et al. EAE/ASE recommendations for the use of echocardiography in new transcatheter interventions for valvular heart disease. J Am Soc Echocardiogr. 2011;24:937–65. This document provides a detailed description of the use of 2-D and 3D echcoardiography in transcatheter valvular interventions.PubMedCrossRef
2.
go back to reference Bloomfield GS, Gillam LD, Hahn RT, et al. A practical guide to multimodality imaging of transcatheter aortic valve replacement. JACC Cardiovascr Imaging. 2012;5:441–55.CrossRef Bloomfield GS, Gillam LD, Hahn RT, et al. A practical guide to multimodality imaging of transcatheter aortic valve replacement. JACC Cardiovascr Imaging. 2012;5:441–55.CrossRef
3.
go back to reference •• Piazza N, de Jaegere P, Schultz C, Becker AE, Serruys PW, Anderson RH. Anatomy of the aortic valvar complex and its implications for transcatheter implantation of the aortic valve. Circ Cardiovasc Interv. 2008;1:74–81. This article decribes the anatomy of the aortic valve and root as it pertains to transcatheter aortic valve replacement.PubMedCrossRef •• Piazza N, de Jaegere P, Schultz C, Becker AE, Serruys PW, Anderson RH. Anatomy of the aortic valvar complex and its implications for transcatheter implantation of the aortic valve. Circ Cardiovasc Interv. 2008;1:74–81. This article decribes the anatomy of the aortic valve and root as it pertains to transcatheter aortic valve replacement.PubMedCrossRef
4.
go back to reference Bonow RO, Carabello BA, Chatterjee K, et al. focused update incorporated into the ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to revise the 1998 guidelines for the management of patients with valvular heart disease). Endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. J Am Coll Cardiol. 2008;52(e1). Bonow RO, Carabello BA, Chatterjee K, et al. focused update incorporated into the ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to revise the 1998 guidelines for the management of patients with valvular heart disease). Endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. J Am Coll Cardiol. 2008;52(e1).
5.
go back to reference Delgado V, Tops LF, Schuijf JD, et al. Successful deployment of a transcatheter aortic valve in bicuspid aortic stenosis: role of imaging with multislice computed tomography. Circ Cardiovasc Imaging. 2009;2:e12–3.PubMedCrossRef Delgado V, Tops LF, Schuijf JD, et al. Successful deployment of a transcatheter aortic valve in bicuspid aortic stenosis: role of imaging with multislice computed tomography. Circ Cardiovasc Imaging. 2009;2:e12–3.PubMedCrossRef
6.
go back to reference • Messika-Zeitoun D, Serfaty J-M, Brochet E, et al. Multimodal assessment of the aortic annulus diameter: implications for transcatheter aortic valve implantation. J Am Coll Cardiol. 2010;55:186–94. This artcle was the first to emphasize the oval shape of the aortic annulus and its implications for determining aortic annular dimentions for transcatheter aortic valve replacement.PubMedCrossRef • Messika-Zeitoun D, Serfaty J-M, Brochet E, et al. Multimodal assessment of the aortic annulus diameter: implications for transcatheter aortic valve implantation. J Am Coll Cardiol. 2010;55:186–94. This artcle was the first to emphasize the oval shape of the aortic annulus and its implications for determining aortic annular dimentions for transcatheter aortic valve replacement.PubMedCrossRef
7.
go back to reference • Altiok E, Koos R, Schröder J, et al. Comparison of two-dimensional and three-dimensional imaging techniques for measurement of aortic annulus diameters before transcatheter aortic valve implantation. Heart. 2011;97:1578–84. This article shows a good correlation for saggital and coronal aortic annular diemters measured by 3-D TEE and CT.PubMedCrossRef • Altiok E, Koos R, Schröder J, et al. Comparison of two-dimensional and three-dimensional imaging techniques for measurement of aortic annulus diameters before transcatheter aortic valve implantation. Heart. 2011;97:1578–84. This article shows a good correlation for saggital and coronal aortic annular diemters measured by 3-D TEE and CT.PubMedCrossRef
8.
go back to reference Ng ACT, Delgado V, van der Kley F, et al. Comparison of aortic root dimensions and geometries before and after transcatheter aortic valve implantation by 2- and 3-dimensional transesophageal echocardiography and multislice computed tomography. Circ Cardiovasc Imaging. 2010;3:94–102.PubMedCrossRef Ng ACT, Delgado V, van der Kley F, et al. Comparison of aortic root dimensions and geometries before and after transcatheter aortic valve implantation by 2- and 3-dimensional transesophageal echocardiography and multislice computed tomography. Circ Cardiovasc Imaging. 2010;3:94–102.PubMedCrossRef
9.
go back to reference Leon MB, Smith CR, Mack M, et al. Transcatheter aortic-valve implantation for aortic stenosis in patients who cannot undergo surgery. N Engl J Med. 2010;363:1597–607.PubMedCrossRef Leon MB, Smith CR, Mack M, et al. Transcatheter aortic-valve implantation for aortic stenosis in patients who cannot undergo surgery. N Engl J Med. 2010;363:1597–607.PubMedCrossRef
10.
go back to reference Makkar RR, Fontana GP, Jilaihawi H, et al. Transcatheter aortic-valve replacement for inoperable severe aortic stenosis. N Engl J Med. 2012;366:1696–704.PubMedCrossRef Makkar RR, Fontana GP, Jilaihawi H, et al. Transcatheter aortic-valve replacement for inoperable severe aortic stenosis. N Engl J Med. 2012;366:1696–704.PubMedCrossRef
11.
go back to reference Ussia GP, Barbanti M, Petronio AS, et al. Transcatheter aortic valve implantation: 3-year outcomes of self-expanding CoreValve prosthesis. Eur Heart J. 2012;33:969–76.PubMedCrossRef Ussia GP, Barbanti M, Petronio AS, et al. Transcatheter aortic valve implantation: 3-year outcomes of self-expanding CoreValve prosthesis. Eur Heart J. 2012;33:969–76.PubMedCrossRef
12.
go back to reference Gurvitch R, Wood DA, Tay EL, et al. Transcatheter Aortic valve implantation: durability of clinical and hemodynamic outcomes beyond 3 years in a large patient cohort. Circulation. 2010;122:1319–27.PubMedCrossRef Gurvitch R, Wood DA, Tay EL, et al. Transcatheter Aortic valve implantation: durability of clinical and hemodynamic outcomes beyond 3 years in a large patient cohort. Circulation. 2010;122:1319–27.PubMedCrossRef
13.
go back to reference Abdel-Wahab M, Zahn R, Horack M, et al. Aortic regurgitation after transcatheter aortic valve implantation: incidence and early outcome. Results from the German transcatheter aortic valve interventions registry. Heart. 2011;97:899–906.PubMedCrossRef Abdel-Wahab M, Zahn R, Horack M, et al. Aortic regurgitation after transcatheter aortic valve implantation: incidence and early outcome. Results from the German transcatheter aortic valve interventions registry. Heart. 2011;97:899–906.PubMedCrossRef
14.
go back to reference Tamburino C, Capodanno D, Ramondo A, et al. Incidence and predictors of early and late mortality after transcatheter aortic valve implantation in 663 patients with severe aortic stenosis / clinical perspective. Circulation. 2011;123:299–308.PubMedCrossRef Tamburino C, Capodanno D, Ramondo A, et al. Incidence and predictors of early and late mortality after transcatheter aortic valve implantation in 663 patients with severe aortic stenosis / clinical perspective. Circulation. 2011;123:299–308.PubMedCrossRef
15.
go back to reference Masson J-B, Kovac J, Schuler G, et al. Transcatheter aortic valve implantation: review of the nature, management, and avoidance of procedural complications. JACC Cardiovasc Intervent. 2009;2:811–20.CrossRef Masson J-B, Kovac J, Schuler G, et al. Transcatheter aortic valve implantation: review of the nature, management, and avoidance of procedural complications. JACC Cardiovasc Intervent. 2009;2:811–20.CrossRef
16.
go back to reference Leipsic J, Gurvitch R, LaBounty TM, et al. Multidetector computed tomography in transcatheter aortic valve implantation. J Am Coll Cardiol Imaging. 2011;4:416–29. Leipsic J, Gurvitch R, LaBounty TM, et al. Multidetector computed tomography in transcatheter aortic valve implantation. J Am Coll Cardiol Imaging. 2011;4:416–29.
17.
go back to reference Gurvitch R, Cheung A, Ye J, et al. Transcatheter valve-in-valve implantation for failed surgical bioprosthetic valves. J Am Coll Cardiol. 2011;58:2196–209.PubMedCrossRef Gurvitch R, Cheung A, Ye J, et al. Transcatheter valve-in-valve implantation for failed surgical bioprosthetic valves. J Am Coll Cardiol. 2011;58:2196–209.PubMedCrossRef
18.
go back to reference Bagur R, Rodés-Cabau J, Doyle D, et al. Usefulness of TEE as the primary imaging technique to guide transcatheter transapical aortic valve implantation. JACC Cardiovasc Imaging. 2011;4:115–24.PubMedCrossRef Bagur R, Rodés-Cabau J, Doyle D, et al. Usefulness of TEE as the primary imaging technique to guide transcatheter transapical aortic valve implantation. JACC Cardiovasc Imaging. 2011;4:115–24.PubMedCrossRef
19.
go back to reference • Shames S, Koczo A, Hahn R, et al. Flow characteristics of the sapien aortic valve: the importance of recognizing in-stent flow acceleration for the echocardiographic assessment of valve function. J Am Soc Echocardiogr 2012;25:603–9. This article is the first to demonstrate a two-step acceleration of flow of the Edwards SAPIEN valve: at the level of the stent and the valve cusps, emphasizing the importance of samling the left ventricular outflow tract velocity right before the proximal end of the valve stent. • Shames S, Koczo A, Hahn R, et al. Flow characteristics of the sapien aortic valve: the importance of recognizing in-stent flow acceleration for the echocardiographic assessment of valve function. J Am Soc Echocardiogr 2012;25:603–9. This article is the first to demonstrate a two-step acceleration of flow of the Edwards SAPIEN valve: at the level of the stent and the valve cusps, emphasizing the importance of samling the left ventricular outflow tract velocity right before the proximal end of the valve stent.
20.
go back to reference • Clavel M-A, Rodés-Cabau J, Dumont É, et al. Validation and Characterization of transcatheter aortic valve effective orifice area measured by doppler echocardiography. JACC Cardiovasc Imaging. 2011;4:1053–62. This article demonstrates a good correlation of the calculated effective orifice area with grdients of the Edwards SAPIEN valve if the left ventricular outflow tract diameter is measured right proximal to the stent vs. inside the stent.PubMedCrossRef • Clavel M-A, Rodés-Cabau J, Dumont É, et al. Validation and Characterization of transcatheter aortic valve effective orifice area measured by doppler echocardiography. JACC Cardiovasc Imaging. 2011;4:1053–62. This article demonstrates a good correlation of the calculated effective orifice area with grdients of the Edwards SAPIEN valve if the left ventricular outflow tract diameter is measured right proximal to the stent vs. inside the stent.PubMedCrossRef
21.
go back to reference Zoghbi WA, Chambers JB, Dumesnil JG, et al. Recommendations for evaluation of prosthetic valves with echocardiography and doppler ultrasound: a report From the American Society of Echocardiography’s Guidelines and Standards Committee and the Task Force on Prosthetic Valves, developed in conjunction with the American College of Cardiology Cardiovascular Imaging Committee, Cardiac Imaging Committee of the American Heart Association, the European Association of Echocardiography, a registered branch of the European Society of Cardiology, the Japanese Society of Echocardiography and the Canadian Society of Echocardiography, endorsed by the American College of Cardiology Foundation, American Heart Association, European Association of Echocardiography, a registered branch of the European Society of Cardiology, the Japanese Society of Echocardiography, and Canadian Society of Echocardiography. J Am Soc Echocardiogr. 2009;22:975–1014. quiz 1082–4.PubMedCrossRef Zoghbi WA, Chambers JB, Dumesnil JG, et al. Recommendations for evaluation of prosthetic valves with echocardiography and doppler ultrasound: a report From the American Society of Echocardiography’s Guidelines and Standards Committee and the Task Force on Prosthetic Valves, developed in conjunction with the American College of Cardiology Cardiovascular Imaging Committee, Cardiac Imaging Committee of the American Heart Association, the European Association of Echocardiography, a registered branch of the European Society of Cardiology, the Japanese Society of Echocardiography and the Canadian Society of Echocardiography, endorsed by the American College of Cardiology Foundation, American Heart Association, European Association of Echocardiography, a registered branch of the European Society of Cardiology, the Japanese Society of Echocardiography, and Canadian Society of Echocardiography. J Am Soc Echocardiogr. 2009;22:975–1014. quiz 1082–4.PubMedCrossRef
22.
go back to reference Gonçalves A, Almeria C, Marcos-Alberca P, et al. Three-Dimensional echocardiography in paravalvular aortic regurgitation assessment after transcatheter aortic valve implantation. J Am Soc Echocardiogr. 2012;25:47–55.PubMedCrossRef Gonçalves A, Almeria C, Marcos-Alberca P, et al. Three-Dimensional echocardiography in paravalvular aortic regurgitation assessment after transcatheter aortic valve implantation. J Am Soc Echocardiogr. 2012;25:47–55.PubMedCrossRef
23.
go back to reference Leon MB, Piazza N, Nikolsky E, et al. Standardized endpoint definitions for transcatheter aortic valve implantation clinical trials: a consensus report from the valve academic research consortium. J Am Coll Cardiol. 2011;57:253–69.PubMedCrossRef Leon MB, Piazza N, Nikolsky E, et al. Standardized endpoint definitions for transcatheter aortic valve implantation clinical trials: a consensus report from the valve academic research consortium. J Am Coll Cardiol. 2011;57:253–69.PubMedCrossRef
24.
go back to reference Feldman T, Cilingiroglu M. Percutaneous leaflet repair and annuloplasty for mitral regurgitation. J Am Coll Cardiol. 2011;57:529–37.PubMedCrossRef Feldman T, Cilingiroglu M. Percutaneous leaflet repair and annuloplasty for mitral regurgitation. J Am Coll Cardiol. 2011;57:529–37.PubMedCrossRef
25.
go back to reference Feldman T, Foster E, Glower DD, et al. Percutaneous Repair or surgery for mitral regurgitation. N Engl J Med. 2011;364:1395–406.PubMedCrossRef Feldman T, Foster E, Glower DD, et al. Percutaneous Repair or surgery for mitral regurgitation. N Engl J Med. 2011;364:1395–406.PubMedCrossRef
26.
go back to reference Feldman T, Kar S, Rinaldi M, et al. Percutaneous mitral repair with the mitraclip system: safety and midterm durability in the initial EVEREST (Endovascular Valve Edge-to-Edge REpair Study) Cohort. J Am Coll Cardiol. 2009;54:686–94.PubMedCrossRef Feldman T, Kar S, Rinaldi M, et al. Percutaneous mitral repair with the mitraclip system: safety and midterm durability in the initial EVEREST (Endovascular Valve Edge-to-Edge REpair Study) Cohort. J Am Coll Cardiol. 2009;54:686–94.PubMedCrossRef
27.
go back to reference Grayburn PA, Roberts BJ, Aston S, et al. Mechanism and severity of mitral regurgitation by transesophageal echocardiography in patients referred for percutaneous valve repair. Am J Cardiol. 2011;108:882–7.PubMedCrossRef Grayburn PA, Roberts BJ, Aston S, et al. Mechanism and severity of mitral regurgitation by transesophageal echocardiography in patients referred for percutaneous valve repair. Am J Cardiol. 2011;108:882–7.PubMedCrossRef
28.
go back to reference Ben Zekry S, Nagueh SF, Little SH, et al. Comparative accuracy of two- and three-dimensional transthoracic and transesophageal echocardiography in identifying mitral valve pathology in patients undergoing mitral valve repair: initial observations. J Am Soc Echocardiogr. 2011;24:1079–85.PubMedCrossRef Ben Zekry S, Nagueh SF, Little SH, et al. Comparative accuracy of two- and three-dimensional transthoracic and transesophageal echocardiography in identifying mitral valve pathology in patients undergoing mitral valve repair: initial observations. J Am Soc Echocardiogr. 2011;24:1079–85.PubMedCrossRef
29.
go back to reference La Canna G, Arendar I, Maisano F, et al. Real-time three-dimensional transesophageal echocardiography for assessment of mitral valve functional anatomy in patients with prolapse-related regurgitation. Am J Cardiol. 2011;107:1365–74.PubMedCrossRef La Canna G, Arendar I, Maisano F, et al. Real-time three-dimensional transesophageal echocardiography for assessment of mitral valve functional anatomy in patients with prolapse-related regurgitation. Am J Cardiol. 2011;107:1365–74.PubMedCrossRef
30.
go back to reference Foster E, Wasserman HS, Gray W, et al. Quantitative assessment of severity of mitral regurgitation by serial echocardiography in a multicenter clinical trial of percutaneous mitral valve repair. Am J Cardiol. 2007;100:1577–83.PubMedCrossRef Foster E, Wasserman HS, Gray W, et al. Quantitative assessment of severity of mitral regurgitation by serial echocardiography in a multicenter clinical trial of percutaneous mitral valve repair. Am J Cardiol. 2007;100:1577–83.PubMedCrossRef
31.
go back to reference Rihal CS, Sorajja P, Booker JD, Hagler DJ, Cabalka AK. Principles of percutaneous paravalvular leak closure. JACC Cardiovasc Intervent. 2012;5:121–30.CrossRef Rihal CS, Sorajja P, Booker JD, Hagler DJ, Cabalka AK. Principles of percutaneous paravalvular leak closure. JACC Cardiovasc Intervent. 2012;5:121–30.CrossRef
Metadata
Title
Role of Echocardiography to Guide New Transcatheter Interventions for Valvular Heart Disease
Authors
Sofia Shames
Linda D. Gillam
Publication date
01-12-2012
Publisher
Current Science Inc.
Published in
Current Cardiovascular Imaging Reports / Issue 6/2012
Print ISSN: 1941-9066
Electronic ISSN: 1941-9074
DOI
https://doi.org/10.1007/s12410-012-9169-x

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