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Highlights from recent EACVI recommendation papers

Imaging


Dr. Victoria Delgado

Chair of EACVI’s Scientific Documents Committee 2016–2018, Doctor Victoria Delgado (University of Leiden, Netherlands), highlighted two recent EACVI recommendation papers as key publications for 2018.

Published in August, an EACVI position paper described the role of multimodality imaging (MMI) in adults with congenital heart disease (ACHD).1 As with other conditions, there is increasing realisation that the diagnostic utility of MMI is greater than the sum of individual tests and integration of this concept into clinical practice for ACHD patients is expected to accelerate in the next decade.  ACHD patients are a heterogeneous population with highly variable previous interventions and as such, are among those with the most to benefit from the appropriate application of MMI. The position paper describes the role of each diagnostic modality in the care of ACHD patients and presents recommendations for an MMI approach, with the focus on providing the most appropriate and cost-effective diagnostic pathway for each individual patient. The authors conclude that, ‘ACHD patients should have the right imaging, at the right place by the right operator at the right time’, which is an important message for all of us involved in cardiac imaging.

In October 2018, EACVI published a timely update on recommendations regarding the use of handheld ultrasound devices (HUD)2. The previous position statement was published in 2011 when HUD had just entered the clinical arena.3 Now, technological advances have led to progressive miniaturisation, with some devices being no larger than many mobile phones, and HUD use is much more widespread. However, the advent of these new tools brings new challenges, such as proficiency in image acquisition, analysis, interpretation, and reporting, which typically requires long-term learning and training. Within the EACVI, it was important to provide guidance in order to achieve maximal benefit for patients in terms of optimal and safety, and to minimise drawbacks from inappropriate use of this technology. The October 2018 update provides recommendations regarding appropriateness, indications, operators, clinical environments, data management and storage, educational needs and training of potential users. It also addresses gaps in evidence, controversial issues and future technological developments.

 

  1. Di Salvo G, et al. Eur Heart J Cardiovasc Imaging. 2018;19:1077–1098.
  2. Cardim N, et al. Eur Heart J Cardiovasc Imaging. 2018 Oct 22. doi: 10.1093/ehjci/jey145. [Epub ahead of print]
  3. Sicari R, et al. Eur J Echocardiogr. 2011;12:85–7.