Revista Española de Cardiología (English Edition) Revista Española de Cardiología (English Edition)
Rev Esp Cardiol. 2018;71:293 - Vol. 71 Num.04 DOI: 10.1016/j.rec.2017.07.001

New Catheter, Wide Angle Imaging, 3D Intracardiac Echocardiography

José Ribeiro a,, Pedro Braga a, Vasco Gama a

a Cardiology Department, Centro Hospitalar Gaia/Espinho, Vila Nova de Gaia, Portugal

Article

During the last few years, the continuous development of intracardiac echocardiography (ICE) has allowed it to play an important role in guiding several interventions in structural heart disease, without the need for general anesthesia. However, the currently available 3-dimensional ICE catheter has a short elevation angle (maximum 90° x 24°), which limits its ability to view complete cardiac structures or devices.

We report the first European clinical use of volume ICE with an enlarged opening angle to guide left atrial appendage (LAA) closure. Interfaced with the ACUSON SC200 ultrasound system (Siemens Healthineers, Erlangen, Germany), the ACUSON AcuNav Volume ICE technology is a 12.5-Fr catheter, capable of obtaining a volume of 90° x 50° with a volume frame rate of 16 volumes per second.

Figure 1 was acquired with the catheter placed in the right atrium and shows the interatrial septum and its relationship with the aortic valve and coronary sinus and can be used to guide the interatrial puncture. Figure 1 was acquired from the left atrium and shows the entire LAA opening. Figure 1 depicts the LAA pulsed-wave flow recording. The LAA multiplanar reconstruction with the circle measurement tool can be viewed in Figure 1, which also shows the circumflex artery (Cx). Figure 1 was acquired at the end of the procedure and shows the Amplatzer device correctly implanted in LAA in 2-dimensional and 3-dimensional views (Video 1 of the supplementary material). Finally, Figure 2 and Figure 2 show all the leaflets of mitral and tricuspid valves (Video 2 of the supplementary material).

Figure 1.

Figure 2.

SUPPLEMENTARY MATERIAL

Video 1

Video 2

Corresponding author: cardiogaia@gmail.com

1885-5857/© 2018 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved

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