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Catheter-based interventions guided solely by a new phased-array intracardiac imaging catheter: in vivo experimental
Ismail T Dairywala1, Peng Li, Zheng Liu
1Division of Cardiology, Department of Internal Medicine, University of Michigan Health System, Ann Arbor, MI, USA.
Background:
Intracardiac echocardiography (ICE) has had useful but limited use during interventional procedures because of technologic limitations. We used a novel phased-array ICE device (AcuNav) with 2-dimensional sector imaging and full Doppler capability to see whether it could guide cardiac interventions without fluoroscopy.
Methods:
Twelve dogs were studied, and we performed atrial septostomy, tricuspid, and pulmonary valve disruption using only ICE. Preinterventional and postinterventional anatomic and hemodynamic data were noted.
Results:
All attempts were successful in the placement of the ICE catheter (100%). We attempted septostomy on 11 dogs and were successful 8 times (73%). Tricuspid valve disruption and balloon dilatation were performed successfully on 5 dogs (100%). We attempted pulmonary valve disruption on 4 dogs and could always correctly place the guidewire (100%). We performed pulmonary valve balloon dilatation on one dog (25%). A comprehensive echocardiographic examination was always possible.
Conclusion:
This new ICE device can guide interventions without fluoroscopy. However, further studies are needed to evaluate whether it can replace fluoroscopy.