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Fusion Imaging for Structural Heart Disease Interventions

  • Echocardiography (T Schindler, Section Editor)
  • Published:
Current Cardiovascular Imaging Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Accurate procedural guidance is necessary for structural heart disease (SHD) interventions to reduce procedural times and improve results. Fluoroscopy remains the foundation imaging modality for guidance of transcatheter therapy. However, fluoroscopy has limitations in that it only provides 2D projections of complex 3D anatomy. Fusion technology has the capability to project cardiac imaging, including echocardiography and computed tomography (CT), onto fluoroscopy for a more complete representation of the anatomy to help guide SHD interventions. This in turn allows for a more effective workflow that may improve safety and efficacy while decreasing procedural times, radiation exposure, and contrast dosage. This review focuses on the use of fusion imaging for SHD interventions.

Recent Findings

Recent studies support the feasibility of fusion imaging for a variety of SHD interventions. The impact of fusion imaging on operator confidence, procedural success rates, and outcome measures, such as procedure time and radiation exposure, are currently being evaluated.

Summary

The use of echocardiography-fluoroscopy and computed tomography angiography (CTA)-fluoroscopy fusion imaging has been established for a multitude of SHD interventions. While fusion imaging has the potential to improve SHD interventions, data is mainly limited to observational studies. Therefore, future studies are needed to evaluate if fusion imaging leads to an improvement in procedural success and a reduction in procedural time, radiation exposure, and contrast dose.

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Abbreviations

CTA:

Computed tomography angiography

ICE:

Intracardiac echocardiography

LAA:

Left atrial appendage

MR:

Magnetic resonance imaging

PVL:

Paravalvular leak

PMVR:

Percutaneous mitral valve repair

RT-3D:

Real-time three-dimensional

SHD:

Structural heart disease

TAVR:

Transaortic valve replacement

TEE:

Transesophageal echocardiography

TTE:

Transthoracic echocardiography

TS:

Transseptal puncture

ViV:

Valve-in-valve

ViR:

Valve-in-ring

References

Papers of particular interest, published recently, have been highlighted as: •• Of major importance

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Authors and Affiliations

  1. Department of Cardiovascular Medicine, Lenox Hill Hospital, Northwell Health, 100 East 77th St., 2nd Floor Noninvasive Cardiology, New York, NY, 10075, USA

    Craig Basman, Yuvrajsinh J. Parmar, Chad Kliger & Itzhak Kronzon

  2. The Structural and Congenital Heart Center Hackensack Meridian Health, Hackensack, NJ, USA

    Vladimir Jelnin, Tilak K. R. Pasala & Carlos E. Ruiz

Authors
  1. Craig Basman
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  2. Yuvrajsinh J. Parmar
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  3. Chad Kliger
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  4. Vladimir Jelnin
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  5. Tilak K. R. Pasala
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  6. Carlos E. Ruiz
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  7. Itzhak Kronzon
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Corresponding author

Correspondence to Itzhak Kronzon.

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Conflict of Interest

Craig Basman, Tilak K.R. Pasala, and Yuvrajsinh Parmar have no conflicts of interest.

Itzhak Kronzon, Chad Kliger, Vladimir Jelnin, and Carlos E. Ruiz receive consulting fees from Philips.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

This article is part of the Topical Collection on Echocardiography

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Basman, C., Parmar, Y.J., Kliger, C. et al. Fusion Imaging for Structural Heart Disease Interventions. Curr Cardiovasc Imaging Rep 10, 41 (2017). https://doi.org/10.1007/s12410-017-9436-y

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  • DOI: https://doi.org/10.1007/s12410-017-9436-y

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