Echopixel 3d Ct vs. Transesophageal Echocardiography for Pre-Procedural Planning of Watchman Implantation

Dutcher, Jacob R.; Schmidt, William D.; Dahl, Peggy; Humbert, J

doi:10.1016/s0735-1097(20)31833-7

Cited by 3 publications

(4 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…2, respectively). The difference between our findings and the study by Eng et al may be explained by the smaller study group, different device used, and by the use of 2D-TEE, which is much less accurate than 3D-TEE[28,32].Dutcher et al[31] compared a CT-guided and TEE-guided strategy in 154 consecutive patients (CT n = 76 vs. TEE n = 78) who received the WATCHMAN device. The authors of this study reported a significantly better accuracy rate concerning first device selection in the CT group with 86.7% for the CT-guided group vs 75.6% for the TEE group (p = 0.041).…”

contrasting

confidence: 81%

“…There are only a few studies that have examined the influence of preprocedural CCT and TEE versus TEE alone, in terms of procedure time, contrast use, correct device size and number of devices utilized. Two small studies have shown a significant reduction in procedure time and anesthesia time, a greater accuracy in device selection, and an absence of peri-device leaks in the group that received a preprocedural CCT [30,31]. However, data on the influence of preprocedural CCT, concerning the periprocedural and long-term transesophageal echocardiographic outcome, are scarce.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Cardiac Computed Tomography versus 3D-Transesophageal Echocardiography in Preprocedural Planning of Left Atrial Appendage Closure

Omran¹

2021

JCCI

View full text Add to dashboard Cite

Aim: Preprocedural imaging of the left atrial appendage (LAA) plays a crucial role in the process of LAA closure (LAAC). This study aimed to compare the influence of preprocedural planning of the LAAC with 3D-transesophageal echocardiography (TEE) and cardiac computed tomography (CCT) versus 3D-TEE alone in patients who underwent LAAC with an Amplatzer Cardiac Plug or Amulet. Materials and Methods: In a retrospective study, 176 patients received a preprocedural 3D-TEE and CCT and 167 patients a 3D-TEE only. Both groups had similar patient characteristics and indications for LAAC. Results: There was no difference in terms of procedural success, procedure time, amount of contrast medium, fluoroscopy time, or radiation dose. Patients with CCT/3D-TEE had a longer hospital stay on average. Besides, there was a different incidence of renal diseases (49% for 3D-TEE versus 27% for CCT/3D-TEE; p < 0.001). The number of periprocedural adverse events was comparable. A device-related thrombus occurred three times in each group, and the peri-device leaks reported were similar. Conclusion: A preprocedural CCT does not decrease major adverse events or improve outcome in patients undergoing LAAC.

show abstract

contrasting

confidence: 81%

Section: Introductionmentioning

confidence: 99%

Cardiac Computed Tomography versus 3D-Transesophageal Echocardiography in Preprocedural Planning of Left Atrial Appendage Closure

Omran¹

2021

JCCI

View full text Add to dashboard Cite

show abstract

“…Brun et al [13] validated the use of Mixed Reality for visualization of CTA images in congenital heart patients demonstrating that 3D experience contributed to better understanding of complex heart anatomy. Dutcher et al [14] conducted a prospective study of use of EchoPixel VR technology for CT image visualization, manipulation, and measurements in patient undergoing left atrial appendage occlusion procedure. The VR-based pre-procedural planning was associated with a reduction of procedure time and led to a greater accuracy of WATCHMAN device selection compared to a control group undergoing only the 3D-TEE imaging.…”

Section: Extended Reality For Surgical and Interventionalmentioning

confidence: 99%

Augmented, Virtual and Robotic Capabilities in Cardiovascular Program Capacity Building

Gupta

Metzke

Struk

et al. 2021

Sustainable Development Goals Series

View full text Add to dashboard Cite

The role of technology in ecosystem partnerships is to augment local skills and capacity in health services delivery, and to better connect information and health professionals in a way that enables them to take on new roles to help each other. Technology over the past three decades has resulted in dramatic acceleration in the progression from open surgery to minimally invasive, image-guided therapy (IGT). Today, imaging technologies like X-ray and ultrasound allow real-time, in-body visualization of instruments and anatomy without the need for surgical incisions. These advancements coupled with the ongoing miniaturization of endovascular and percutaneous devices have allowed interventional physicians to perform procedures often without general anesthesia and via incisions no larger than a few millimeters. This results in patient recoveries measured in hours to days, rather than weeks as seen with traditional open surgical repairs. Reduced costs, faster recoveries and shortened hospitalization stays are powerful enablers towards capacity building, empowering hospitals to treat more patients per day. Still, new and different skills will be required for doctors, nurses and technologists to perform and support image-guided interventions and minimally invasive surgery and to operate the sophisticated imaging systems, medical devices, and implants that are the backbone of these procedures. This chapter will describe how technologies like extended reality and robotics can be enablers of capacity building in LMIC, if enabled by a strong ecosystem partnership.

show abstract

“…In addition to the correct assessment of the diameter, the optimal XR angulations for periprocedural imaging during implantation could be retrieved from the CTA data (21). Even though preprocedural assessment of the LAA based on CTA has the potential to improve the outcome and efficiency of the intervention (22,23), its application is limited in patients with reduced kidney performance and due to its intrinsic risk of ionizing radiation is under safety/benefit debate for general application in LAAc (24). Here, cardiac magnetic resonance imaging (CMR) may gain interest especially considering the additional excellent soft-tissue contrast, enabling thrombus detection in the LAA (25, 26).…”

Section: Introductionmentioning

confidence: 99%

Cardiac magnetic resonance imaging for preprocedural planning of percutaneous left atrial appendage closure

Bertsche

Metze

Luo

et al. 2023

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

IntroductionPercutaneous closure of the left atrial appendage (LAA) facilitates stroke prevention in patients with atrial fibrillation. Optimal device selection and positioning are often challenging due to highly variable LAA shape and dimension and thus require accurate assessment of the respective anatomy. Transesophageal echocardiography (TEE) and x-ray fluoroscopy (XR) represent the gold standard imaging techniques. However, device underestimation has frequently been observed. Assessment based on 3-dimensional computer tomography (CTA) has been reported as more accurate but increases radiation and contrast agent burden. In this study, the use of non-contrast-enhanced cardiac magnetic resonance imaging (CMR) to support preprocedural planning for LAA closure (LAAc) was investigated.MethodsCMR was performed in thirteen patients prior to LAAc. Based on the 3-dimensional CMR image data, the dimensions of the LAA were quantified and optimal C-arm angulations were determined and compared to periprocedural data. Quantitative figures used for evaluation of the technique comprised the maximum diameter, the diameter derived from perimeter and the area of the landing zone of the LAA.ResultsPerimeter- and area-based diameters derived from preprocedural CMR showed excellent congruency compared to those measured periprocedurally by XR, whereas the respective maximum diameter resulted in significant overestimation (p < 0.05). Compared to TEE assessment, CMR-derived diameters resulted in significantly larger dimensions (p < 0.05). The deviation of the maximum diameter to the diameters measured by XR and TEE correlated well with the ovality of the LAA. C-arm angulations used during the procedures were in agreement with those determined by CMR in case of circular LAA.DiscussionThis small pilot study demonstrates the potential of non-contrast-enhanced CMR to support preprocedural planning of LAAc. Diameter measurements based on LAA area and perimeter correlated well with the actual device selection parameters. CMR-derived determination of landing zones facilitated accurate C-arm angulation for optimal device positioning.

show abstract

Echopixel 3d Ct vs. Transesophageal Echocardiography for Pre-Procedural Planning of Watchman Implantation

Cited by 3 publications

References 0 publications

Cardiac Computed Tomography versus 3D-Transesophageal Echocardiography in Preprocedural Planning of Left Atrial Appendage Closure

Cardiac Computed Tomography versus 3D-Transesophageal Echocardiography in Preprocedural Planning of Left Atrial Appendage Closure

Augmented, Virtual and Robotic Capabilities in Cardiovascular Program Capacity Building

Cardiac magnetic resonance imaging for preprocedural planning of percutaneous left atrial appendage closure

Contact Info

Product

Resources

About