Usefulness of Doppler echocardiography guidance during balloon aortic valvuloplasty for the treatment of congenital aortic stenosis

Safety and efficiency of the new micro-multiplane transoesophageal probe in paediatric cardiology

“…The procedure was successful and TOE guidance avoided unnecessary oversized dilation and subsequent risk of aortic insufficiency [23]. Echo-guidance also allows lower fluoroscopy time and lower contrast load [23]. Furthermore, this case illustrates how the cardiovascular imaging specialists and interventionalists can work together effectively to plan and execute catheter interventions for congenital heart disease [2].…”

“…TOE allowed a step-by-step dilation procedure with closed assessment of aortic valve gradient and continence. The procedure was successful and TOE guidance avoided unnecessary oversized dilation and subsequent risk of aortic insufficiency [23]. Echo-guidance also allows lower fluoroscopy time and lower contrast load [23].…”

Percutaneous aortic balloon valvuloplasty under echocardiographic guidance solely

“…Balloon aortic valvuloplasty (BAV) for the management of patients with severe congenital AS, was first reported in 1984 by Lababidi, as an "alternative treatment whenever surgical valve replacement proved impracticable" (1), even if in the era of transcatheter aortic valve replacement, PBAV still owns its practicability. The BAV technique has experienced minor changes since its introduction and use of angiographic guidance has prevailed; however, Doppler echocardiography has been used increasingly in cardiac catheterization laboratories to guide congenital heart disease interventions (2)(3)(4). Because interventional cardiac catheterizations are among the radiological procedures with the highest patient and physician X-ray radiation dose ( 10), many studies have demonstrated higher incidence of chromosomal damage, a marker of carcinogenesis, cancer and even patient cardiovascular damage (10)(11)(12)(13)(14)(15).…”

“…Percutaneous balloon aortic valvuloplasty (PBAV) is an alternative to surgical valvulotomy for the treatment of congenital aortic stenosis (AS) (1). Although PBAV is traditionally conducted under angiographic guidance, in recent years, Doppler echocardiography has been increasingly used in the catheterization laboratory to guide congenital heart disease interventions, however, few cases of successful BAV guided solely by transesophageal echocardiography (TEE) have been reported (2)(3)(4). We have performed successfully non-fluoroscopy guided patients with congenital AS underwent PBAV at our hospital.…”

A Practical Approach to Managing Transcatheter Aortic Valve Replacement With Sedation

“…TTE has already proven to be an effective imaging tool for procedural guidance in balloon aortic valvuloplasty 50 and there is literature reporting its efficacy in TAVR. In a retrospective study performed by Sengupta and colleagues, TAVR procedures using TTE and sedation showed no changes in procedural success or rate of complications while also decreasing procedure time compared to TAVR procedures using TEE and GA. 51 While sterility during TTE examination remains a concern, commercially available plastic covers for the TTE probe can be used to avoid compromising the surgical field.…”