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Transthoracic and Transesophageal Echocardiography in Interventional Cardiovascular Catheter-Based Therapy

  • Ratnasari Padang
  • Sunil V. Mankad
Chapter

Abstract

Transcatheter-based cardiovascular intervention for structural heart disease—and, with it, interventional echocardiography—is a rapidly evolving field. While historically these catheterization laboratory–based interventions were performed under fluoroscopy and angiography guidance, the increasing procedural complexities seen nowadays have necessitated precise periprocedural imaging guidance, as procedural mishaps often translate into devastating outcomes. With this realization, the use of echocardiography has become an integral part of today’s catheter-based interventions, from patient selection to intraprocedural monitoring to postprocedural follow-up. Undeniably, echocardiography represents the ideal technique for intraprocedural guidance, as it provides superior delineation of cardiac anatomy and pathology, allows real-time visualization of intracardiac structures and catheters, is portable, and permits a reduction in radiation exposure from fluoroscopy. It is important to recognize that echocardiography for guidance of transcatheter-based cardiovascular intervention poses different demands from those of routine evaluation of patients with structural heart disease. This chapter is therefore intended to provide practical guidance for echocardiographers participating in various catheter-based cardiovascular interventions, with particular emphasis on the utility of transthoracic and transesophageal echocardiography in guiding these procedures.

Notes

Acknowledgments

The authors acknowledge the support received from the Division of Cardiovascular Ultrasound, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA, during the preparation of this manuscript.

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Authors and Affiliations

  1. 1.Department of Cardiovascular DiseasesMayo ClinicRochesterUSA

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