Insights Gained From Three-Dimensional Imaging Modalities for Closure of Ventricular Septal Defects

Charakida, Marietta; Pushparajah, Kuberan; Anderson, David; Simpson, John

doi:10.1161/circimaging.114.002502

Cited by 16 publications

(9 citation statements)

References 51 publications

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“…Aside from echocardiography, other imaging modalities for diagnosing VSD include CT angiography and cardiac MRI. The advantages of echocardiography for diagnosing VSD include its ready availability and its ability to interrogate the VSD with Doppler assessment 5 . The main disadvantage of echocardiography, as mentioned above, is that limited acoustic windows could lead to suboptimal imaging, potentially leading to false negative diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Incidence of acquired ventricular septal defect after transcatheter aortic valve replacement: A large single center experience

Nona

Mahmood

Lemor

et al. 2021

Cathet Cardio Intervent

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Objective To determine the rate and clinical outcomes of post‐TAVR VSD. Background Transcatheter aortic valve replacement (TAVR) is a safe and established procedure for patients with severe symptomatic aortic stenosis. Ventricular septal defect (VSD) is a rare complication of TAVR. The rate of post‐TAVR VSD and patient outcomes are not well known. Methods A retrospective record review of VSD cases occurring after all TAVRs performed between January 2012 and September 2020 at one urban US tertiary hospital. VSD rate and early‐ and long‐term outcomes were analyzed. Computed tomography images taken before TAVR and transthoracic echocardiograms done before and after each procedure were analyzed. Results Of the 1908 patients who underwent TAVR in the study period, 7 patients (0.37%) had post‐procedure VSD. The average patient age was 77 ± 11 years with average society of thoracic surgeons short‐term risk score of 6%. All 7 implanted valves were balloon‐expandable. Of the 7 TAVR procedures, 5 were performed on a native tricuspid valve, 1 was performed on a native bicuspid valve, and 1 was done as a “valve‐in‐valve” procedure on a prior surgical bioprosthetic valve. All VSDs were small and restrictive in nature. Right heart failure in a patient with preexisting right ventricular dysfunction occurred in 1 (13%) patient who died. The remaining 6 patients (86%) were discharged. All 6 patients (86%) were alive and stable at 1 year follow‐up, reporting improvement in symptoms (NYHA class I‐II), with no evidence of right ventricular dysfunction. Conclusion VSD is a rare complication of TAVR. Hemodynamic and clinical sequelae in majority of the patients in this study did not result in mortality. Proper imaging techniques and appropriate pre‐procedure planning are needed to decrease the incidence of VSD formation post‐TAVR.

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Section: Discussionmentioning

confidence: 99%

Incidence of acquired ventricular septal defect after transcatheter aortic valve replacement: A large single center experience

Nona

Mahmood

Lemor

et al. 2021

Cathet Cardio Intervent

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“…Real-time 3DE allows a unique en face view of VSDs from the right or left ventricular side and a complete evaluation of relative changes in VSD area throughout the cardiac cycle, with an overall acquisition time close to that of a 2DE study ( 33 ). Then, it better defines perimembranous ventricular septal aneurysms, especially regarding the presence and extension of accessory tricuspid tissue ( 34 ); it permits to visualize the tricuspid valve chords and the defect in a single projection as well as to exclude the presence of aortic valve prolapse, which can be difficult to visualize on 2DE ( 35 ).…”

Section: Echo-guidance In the Cath-lab: Clinical Applicationsmentioning

confidence: 99%

Renaissance of Cardiac Imaging to Assist Percutaneous Interventions in Congenital Heart Diseases:The Role of Three-Dimensional Echocardiography and Multimodality Imaging

et al. 2022

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Percutaneous interventions have completely refashioned the management of children with congenital heart diseases (CHD) and the use of non-invasive imaging has become the gold standard to plan and guide these procedures in the modern era. We are now facing a dual challenge to improve the standard of care in low-risk patients, and to shift our strategies from the classic open chest surgery to imaging-guided percutaneous interventions in high-risk patients. Such rapid evolution of ultrasound technologies over the last 20 years have permitted the integration of transthoracic, transesophageal and intracardiac echocardiography into the interventional workflow to improve image guidance and reduce radiation burden from fluoroscopy and angiography. Specifically, miniaturization of transesophageal probe and advances in three-dimensional (3D) imaging techniques have enabled real-time 3D image guidance during complex interventional procedure, In addition, multimodality and fusion imaging techniques harness the strengths of different modalities to enhance understanding of anatomical and spatial relationship between different structures, improving communication and coordination between interventionalists and imaging specialists. In this review, we aim to provide an overview of 3D imaging modalities and multimodal fusion in procedural planning and live guidance of percutaneous interventions. At the present times, 3D imaging can no longer be considered a luxury but a routine clinical tool to improve procedural success and patient outcomes.

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“…There are published standards for image acquisition, post-processing, and display of 3D echocardiographic imaging in CHD (6). It is particularly useful for en-face 3D projections of septal walls for evaluation of septal defects, providing an improved appreciation of rims of a defect and its relationship to surrounding structures (7)(8)(9). Improvements in matrix array probes and software also allow for rapid image acquisition in a routine clinical workflow even in small babies and children with fast heart rates without the need for breath-holds (9).…”

Section: D Echocardiographymentioning

confidence: 99%

Non-invasive Imaging in the Evaluation of Cardiac Shunts for Interventional Closure

Pushparajah

2021

Front. Cardiovasc. Med.

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Insights Gained From Three-Dimensional Imaging Modalities for Closure of Ventricular Septal Defects

Cited by 16 publications

References 51 publications

Incidence of acquired ventricular septal defect after transcatheter aortic valve replacement: A large single center experience

Incidence of acquired ventricular septal defect after transcatheter aortic valve replacement: A large single center experience

Renaissance of Cardiac Imaging to Assist Percutaneous Interventions in Congenital Heart Diseases:The Role of Three-Dimensional Echocardiography and Multimodality Imaging

Non-invasive Imaging in the Evaluation of Cardiac Shunts for Interventional Closure

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