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Related Experiment Video

Updated: Jun 21, 2026

A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair

A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair

Published on: October 16, 2021

A fully echo-guided trans-apical aortic valve implantation.

Enrico Ferrari¹, Christopher Sulzer, Elena Rizzo

¹Department of Cardio-Vascular Surgery, University Hospital of Lausanne (CHUV), 46 Rue du Bugnon, CH-1011 Lausanne, Switzerland. enricoferrari@bluewin.ch

European Journal of Cardio-Thoracic Surgery : Official Journal of the European Association for Cardio-Thoracic Surgery

|August 18, 2009

Summary

This study introduces a novel, contrast-free trans-apical aortic valve implantation (TA-AVI) technique. This echo-guided approach preserves renal function in high-risk patients with kidney insufficiency.

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Area of Science:

Cardiology
Medical Imaging
Surgical Innovation

Background:

Trans-apical aortic valve implantation (TA-AVI) is a key procedure for high-risk patients needing aortic valve replacement.
Conventional TA-AVI relies on contrast-enhanced imaging (CT, angiography, fluoroscopy) for valve placement.
Contrast agents pose risks, particularly to renal function in elderly patients with chronic kidney insufficiency.

Observation:

A novel TA-AVI procedure was performed using only trans-oesophageal echocardiogram (TOE) guidance.
This technique completely eliminated the need for iodinated contrast media injections.
The procedure was successfully completed in a patient with pre-existing renal insufficiency.

Findings:

The first successful trans-apical aortic valve implantation (TA-AVI) performed entirely with trans-oesophageal echocardiogram (TOE) guidance is reported.

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Improved Registration of 3D CT Angiography with X-ray Fluoroscopy for Image Fusion During Transcatheter Aortic Valve Implantation

Improved Registration of 3D CT Angiography with X-ray Fluoroscopy for Image Fusion During Transcatheter Aortic Valve Implantation

Published on: June 3, 2018

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Last Updated: Jun 21, 2026

A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair

A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair

Published on: October 16, 2021

Improved Registration of 3D CT Angiography with X-ray Fluoroscopy for Image Fusion During Transcatheter Aortic Valve Implantation

Improved Registration of 3D CT Angiography with X-ray Fluoroscopy for Image Fusion During Transcatheter Aortic Valve Implantation

Published on: June 3, 2018

This contrast-free method achieved accurate stent-valve positioning and secure implantation.

The procedure demonstrated the feasibility of echo-guided TA-AVI for renal function preservation.

Implications:

This echo-guided TA-AVI offers a safer alternative for patients with chronic renal insufficiency.
It reduces the risks associated with contrast media in vulnerable patient populations.
This approach may expand the applicability of trans-catheter valve interventions.