Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography
-
J Am Soc Echocardiogr · Sep 2011
Randomized Controlled Trial Comparative StudyIntracardiac echocardiography: a new guiding tool for transcatheter aortic valve replacement.
Echocardiography has been debated as an adjunct for transcatheter aortic valve replacement (TAVR). The aim of this prospective study was to comparatively evaluate intraprocedural guidance using intracardiac echocardiography (ICE) and transesophageal echocardiography (TEE). ⋯ ICE, which is compatible with sedation and local anesthesia, can be considered an alternative to TEE for intraprocedural guidance during TAVR. It also seems to match the required work flow during TAVR better than TEE.
-
J Am Soc Echocardiogr · Sep 2011
ReviewEAE/ASE recommendations for the use of echocardiography in new transcatheter interventions for valvular heart disease.
The introduction of devices for transcatheter aortic valve implantation, mitral repair, and closure of prosthetic paravalvular leaks has led to a greatly expanded armamentarium of catheter-based approaches to patients with regurgitant as well as stenotic valvular disease. Echocardiography plays an essential role in identifying patients suitable for these interventions and in providing intra-procedural monitoring. ⋯ Consequently, the European Association of Echocardiography in partnership with the American Society of Echocardiography has developed the recommendations for the use of echocardiography in new transcatheter interventions for valvular heart disease. It is intended that this document will serve as a reference for echocardiographers participating in any or all stages of new transcatheter treatments for patients with valvular heart disease.
-
J Am Soc Echocardiogr · Sep 2011
Comparative StudyUsefulness of plasma B-type natriuretic peptide in the assessment of disease severity and prediction of outcome after aortic valve replacement in patients with severe aortic stenosis.
The diagnostic and prognostic value of plasma B-type natriuretic peptide (BNP) level in isolated aortic stenosis (AS) has not been fully understood. ⋯ Plasma BNP level reflects the degree of heart failure, is associated with LV structure and function in severe AS, and is an independent predictor of complication and outcome after AVR. BNP level may be useful in risk stratification of patients with AS in conjunction with other clinical and echocardiographic parameters.
-
J Am Soc Echocardiogr · Aug 2011
Comparative StudyRegional myocardial dysfunction following Norwood with right ventricle to pulmonary artery conduit in patients with hypoplastic left heart syndrome.
Improved early survival has led many centers to use the right ventricle-to-pulmonary artery (RVPA) conduit instead of the modified Blalock-Taussig shunt for Norwood palliation of hypoplastic left-heart syndrome. However, there is concern regarding the potential deleterious effects of the required right ventriculotomy for placement of the RVPA conduit on global and regional right ventricular (RV) function. The purpose of this study was to investigate global and regional RV wall motion abnormalities after Norwood palliation with RVPA conduit using Velocity Vector Imaging (VVI). ⋯ In patients with hypoplastic left-heart syndrome after Norwood palliation with RVPA conduit, RV myocardial deformation was significantly reduced at the ventriculotomy site, which persisted after stage 2 palliation. VVI-derived measures demonstrating impairment of global systolic myocardial deformation were correlated with RV systolic function. Long-term multicenter studies to evaluate the effects of ventriculotomy scar on single systemic right ventricle are required.
-
J Am Soc Echocardiogr · Aug 2011
Comparative StudyThe value of three-dimensional echocardiography derived mitral valve parametric maps and the role of experience in the diagnosis of pathology.
Accurate segmental mitral valve (MV) analysis is essential for surgical planning. Although real-time three-dimensional (3D) transesophageal echocardiography has improved the ability to visualize the MV, accurate localization of MV pathology from 3D transesophageal echocardiographic images still remains experience dependent. Three-dimensional parametric maps of the MV obtained from these images further simplify the visualization of MV anatomy. The aims of this study were to examine whether 3D parametric maps of the MV could improve the diagnostic accuracy in localizing pathology and to determine their usefulness for readers with different levels of training. ⋯ This is the first study to show that the interpretation of 3D parametric maps improves the accuracy of localization of MV pathology by novice readers. Therefore, parametric maps should be used routinely by less experienced readers during the assessment of degenerative MV disease.