Cardiovascular Imaging for Guiding Interventional Therapy in Structural Heart Diseases

Area of Science:

• Cardiovascular Medicine
• Medical Imaging
• Interventional Cardiology

Background:

• Interventional cardiology has transformed structural cardiac disease treatment.
• Anatomical variability in defects necessitates advanced imaging for procedural guidance and device selection.
• Novel imaging techniques are integral to current clinical practice for structural interventions.

Purpose of the Study:

• To review the role of modern imaging in pre-procedural assessment for structural percutaneous interventions.
• To highlight the use of imaging techniques for intraprocedural guidance in structural interventions.
• To discuss imaging's application in closing Atrial Septal Defects (ASD), Patent Foramen Ovale (PFO), Left Atrial Appendage (LAA) issues, and patent ductus arteriosus.

Main Methods:

• Three-dimensional echocardiography for enhanced 3D assessment and complication reduction.
• Angiography for real-time imaging, though lacking detailed anatomical description.
• Transesophageal Echocardiography (TEE) and intracardiac ultrasonography for guiding ASD/PFO closure and LAA flow assessment.
• Contrast CT and MRI for detailed structural description, with limitations in flow and mobility assessment.

Main Results:

• Three-dimensional echocardiography improves anatomical assessment and reduces complications from device malalignment.
• TEE is vital for guiding Atrial Septal Defect (ASD) or Patent Foramen Ovale (PFO) closure and assessing Left Atrial Appendage (LAA) flow.
• Advanced imaging techniques provide crucial data for procedural success in structural interventions.

Conclusions:

• Modern imaging modalities are indispensable for the successful execution of percutaneous structural cardiac interventions.
• The choice of imaging technique depends on the specific structural defect and procedural requirements.
• Continued advancements in imaging will further refine the treatment of structural cardiac diseases.