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Guiding Interventions - The aortic valve

EuroEcho-Imaging 2014 session report

Showcase of new and exciting technologies for imaging in aortic interventions demonstrates that rapid progress is afoot.

It was my great pleasure to co-Chair this interesting session with Professor Caiani from Milan and considering the early hour, there was a large audience, so clearly the topic and speakers proved attractive.

Dr Faletra from Lugano started the session and immediately captivated the audience with his beautiful examples of aortic anatomy as seen by 3D TEE.  He correlated these images with pathological specimens and expertly demonstrated anatomical features that are of crucial importance for aortic interventions such as TAVI.  He explained the importance of imaging the aortic anatomy in 3D and compared the strengths and weaknesses of the different imaging modalities to provide the relevant information.

The next presentation was from Dr Ternacle from Paris who discussed the importance of fusion imaging (3D TEE and Fluoro) in the Cath Lab to guide interventions.  He explained how this new technique could reduce X-Ray dose, procedure times and complications. This is definitely a major advance and the audience was left feeling “I want one!”

Dr Mortier from Gent also described some new technology that used sophisticated computer modelling of individual patient anatomy and 3D modelling of TAVI valves to predict what would happen during valve deployment. In other words, a virtual procedure that should help matching of valve size and type to a specific patient. Again, this should help reduce complications of TAVI and prospective trials of the technology are needed to demonstrate its efficacy.

The showcase of new technologies continued with the final presentation from Professor De Jaegere from Rotterdam. He explained how rotational angiography might be used in the Cath Lab, without recourse to other imaging modalities, for valve sizing and other aspects of TAVI planning. 88% of patients had images that were of acceptable quality for analysis and he demonstrated 3 case examples of complications evaluated with this technique. He pointed out that at the moment, this is a work in progress. However, we should all clearly watch this space!

If anyone felt that we already knew all we needed to know about imaging for aortic interventions, this fascinating session should have convinced us that progress in this area is fast and that there many important new technologies just around the corner.  It was a privilege to have co-chaired it.




Guiding Interventions - The aortic valve

The content of this article reflects the personal opinion of the author/s and is not necessarily the official position of the European Society of Cardiology.