Journal of the American Society of Echocardiography
Case ReportsIntracardiac echocardiography using the AcuNav ultrasound catheter during percutaneous balloon mitral valvuloplasty*
Section snippets
Case report
A 47-year-old woman with a medical history significant for a heart murmur known since childhood was referred to the North Shore University Hospital echocardiography laboratory for TTE imaging to evaluate symptoms of progressively worsening dyspnea. On cardiac examination the murmur was noted to be a grade II/VI, low-pitch, diastolic murmur auscultated at the cardiac apex. TTE was performed showing severe rheumatic mitral stenosis with a calculated mitral valve area of 0.7 cm2 using the pressure
Discussion
The use of PBMV for the treatment of patients with pure rheumatic mitral stenosis with a favorable valvuloplasty score has become the treatment of choice. Prior PBMV procedures have relied heavily on fluoroscopy and TEE for imaging. We report the case of the first patient to undergo PBMV using ICE guidance with a 10F, 5- to 10-MHz ultrasound transducer.
The catheter is a new low-frequency (5- to 10-MHz) ultrasound transducer that has many advantages over older types of intracardiac ultrasound
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Cited by (40)
The Role of Intracardiac Echocardiography in Percutaneous Tricuspid Intervention: A New ICE Age
2022, Interventional Cardiology ClinicsCitation Excerpt :ICE was used in 67% of atrial fibrillation ablations and was associated with a lower risk of repeat ablation but with a slightly higher risk of bleeding.27 Also, valve interventions including percutaneous balloon mitral valve valvuloplasty were successfully guided with ICE only.28–30 In a single-center study, ICE was used as an additional imaging tool to fluoroscopy to minimize contrast volume in transcatheter aortic valve replacement.31
Intracardiac Echocardiography
2016, Practice of Clinical EchocardiographyCan we talk? Reflections on effective communication between imager and interventionalist in congenital heart disease
2013, Journal of the American Society of EchocardiographyCitation Excerpt :Others have stressed the advantages of 3D TEE in this setting.38-40 Although TEE is more commonly used, ICE is an alternative for guidance during balloon valvuloplasty for the mitral valve41 or a stenosed prosthetic tricuspid valve.42 Safe implantation of a percutaneous pulmonary valve relies on a good understanding of the anatomy of the right ventricular outflow tract.
Intracardiac echocardiography-guided percutaneous mitral balloon valvuloplasty
2013, Revista Portuguesa de CardiologiaCitation Excerpt :In the 1990s technical improvements led to more generalized use in various structural interventional procedures. The first successful balloon valvuloplasty using ICE was described in 2002 by Salem.6 A 31-year-old woman with known rheumatic mitral valve disease was referred for PMVB.
The present and future of intracardiac echocardiography for guiding structural heart disease interventions
2012, Revista Espanola de CardiologiaEchocardiography-Guided Interventions
2009, Journal of the American Society of EchocardiographyCitation Excerpt :Moreover, some authors have suggested that the use of online TEE can both reduce fluoroscopic and procedure time and improve results71-75 (S. A. Goldstein, personal communication). ICE provides another alternative for online guidance of PBMV.32,48,78 It provides an excellent view of the fossa ovalis and can be used to guide the transseptal puncture.48
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Reprint requests: Judy Mangion, MD, Echocardiography Laboratory, North Shore University Hospital, 300 Community Dr, Manhasset, NY 11030.