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Interventional Echocardiography

  • Chapter
Interventional Cardiology

Part of the book series: Contemporary Cardiology ((CONCARD))

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Abstract

As percutaneous noncoronary interventional cardiology procedures move toward an increasing complex, anatomically based paradigm, procedural guidance with real-time echocardiography has become an important aspect of their successful performance. Traditionally, fluoroscopy as well as angiography has been used for noncoronary procedural guidance in the catheterization laboratory, but significant limitations exist. Fluoroscopy alone is unable to identify important anatomic structures such as the cardiac valves as well as structures such as the coronary sinus ostium, vena cava, and pulmonary veins. Angiography offers some improvement over fluoroscopic-only guidance, but often cannot delineate complex anatomical structures and the relationship between two structures that do not share the same cardiac chamber requires the use of radiographic contrast agents and cannot be performed continuously in real time during the procedure. Furthermore, important targets of therapy such as the mitral valve and fossa ovalis are complex threedimensional structures, and therapeutic devices must be deployed in a precise fashion relative to their anatomy for proper function. During percutaneous noncoronary interventions, echocardiographic guidance assists the interventional cardiologist in the performance of transseptal catheterization, in monitoring guide wire, delivery sheath, and balloon or device position relative to anatomic structures, as well as in the evaluation for thrombus, pericardial effusion, and other procedural complications. This chapter will review the echocardiographic modalities (transthoracic echocardiography, transesophageal echocardiography, and intracardiac echocardiography) used to guide these procedures in the catheterization laboratory. Real-time computed tomography (CT) and magnetic resonance imaging (MRI) guidance of percutaneous noncoronary interventions will be covered in a separate chapter.

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Authors and Affiliations

  1. Cardiovascular Division, Department of Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA

    Frank E. Silvestry MD

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  1. Frank E. Silvestry MD
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Editors and Affiliations

  1. Cardiovascular Division, Department of Medicine, University of Pennsylvania School of Medicine, USA

    Howard C. Herrmann MD (Professor of Medicine, Director) (Professor of Medicine, Director)

  2. Interventional Cardiology and Cardiac Catheterization Laboratories, Hospital of the University of Pennsylvania, Philadelphia, PA

    Howard C. Herrmann MD (Professor of Medicine, Director) (Professor of Medicine, Director)

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© 2005 Humana Press Inc., Totowa, NJ

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Silvestry, F.E. (2005). Interventional Echocardiography. In: Herrmann, H.C. (eds) Interventional Cardiology. Contemporary Cardiology. Humana Press. https://doi.org/10.1385/1-59259-898-6:371

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  • DOI: https://doi.org/10.1385/1-59259-898-6:371

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-58829-367-1

  • Online ISBN: 978-1-59259-898-4

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