Publish in this journal
Journal Information
Vol. 70. Issue 8.
Pages 665 (August 2017)
Image in cardiology
DOI: 10.1016/j.rec.2016.11.019
Full text access
Echo-X Ray Fusion in Paravalvular Leak Closure
Fusión eco-escopia en el cierre de fugas perivalvulares
Visits
...
Manuel Barreiro-Pérez
Corresponding author
manuelbarreiroperez@gmail.com

Corresponding author:
, Ignacio Cruz-González, Pedro L. Sánchez
Servicio de Cardiología, Complejo Asistencial Universitario de Salamanca (CAUSA), Instituto de Investigación Biosanitaria de Salamanca (IBSAL), Salamanca, Spain
This item has received
...
Visits
(Daily data update)
Article information
Full Text
Download PDF
Statistics
Figures (3)
Show moreShow less
Full Text

In patients with paravalvular leaks, between 1% and 5% experience clinical events, and the most common indications for closure are heart failure and hemolysis. The percutaneous approach reduces morbidity and mortality and has become the first-line option. Coordination of echocardiography and fluoroscopy monitoring is made easier with the use of a real-time fusion system (EchoNavigator, Philips). The movement of the C-arm is synchronized with the transesophageal probe, allowing the 2 techniques to be overlaid. The 2-dimensional or 3-dimensional echocardiographic view is automatically shown on the fluoroscopy screen, according to the position of the X-ray tube. The paravalvular leak is located using color Doppler (Figure 1A and Figure 1B) and can be marked: the marker appears overlaid on the fluoroscopy screen (Figure 1C and Figure 1D) and maintains its 3-dimensional position independently of the movement of the C-arm.

Figure 1
(0.18MB).

This system is especially useful in more complex cases, such as closure of a paravalvular leak around a radiolucent bioprosthesis (Figure 2A and Figure 2D). For example, through the use of 2-dimensional orthogonal (X-plane) echocardiography, the fusion system can provide the interventional cardiologist with a reference plane at the moment of fitting and deploying the closure device (Figure 2B and Figure 2C). Another situation that could potentially make use of this technology is the treatment of residual paravalvular leaks after transcatheter aortic valve implantation (Figure 3), as the presence of such leaks affects survival and readmission at follow-up.

Figure 2
(0.16MB).
Figure 3
(0.11MB).
Copyright © 2016. Sociedad Española de Cardiología
Idiomas
Revista Española de Cardiología (English Edition)

Subscribe to our newsletter

Article options
Tools
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

es en
Política de cookies Cookies policy
Utilizamos cookies propias y de terceros para mejorar nuestros servicios y mostrarle publicidad relacionada con sus preferencias mediante el análisis de sus hábitos de navegación. Si continua navegando, consideramos que acepta su uso. Puede cambiar la configuración u obtener más información aquí. To improve our services and products, we use "cookies" (own or third parties authorized) to show advertising related to client preferences through the analyses of navigation customer behavior. Continuing navigation will be considered as acceptance of this use. You can change the settings or obtain more information by clicking here.