JoVE - Journal of Visualized Experiments
JoVE Visualize
Research Domains
View All

Contact Us

Transesophageal Echocardiography and Intracardiac Echocardiography to Guide EVOQUE

  • 1Division of Cardiovascular Medicine, Washington University School of Medicine, St Louis, Missouri, USA. Electronic address: nquader@wustl.edu.
  • 2Division of Cardiothoracic Surgery, Washington University School of Medicine, St Louis, Missouri, USA.
  • 3Division of Cardiovascular Medicine, Washington University School of Medicine, St Louis, Missouri, USA.
+

|

June 13, 2025

Abstract

OBJECTIVE

We demonstrate a step-by-step intraprocedural imaging guide using transesophageal echocardiography (TEE) and intracardiac echocardiography (ICE) to guide EVOQUE in cases with poor intraprocedural imaging.

KEY STEPS

ICE right ventricular (RV) inflow/outflow view with biplane along with 3-dimensional (3D) multiplanar reconstruction (MPR). TEE gastric views for wire placement. ICE 3D MPR to guide delivery system and device depth. Anchors to leaflet relationship; adequate leaflet capture using 3D ICE. Confirm posterior leaflet capture using 2-dimensional (2D) and 3D TEE gastric images. Atrial and ventricular expansion of device using 3D and 2D ICE. 3D MPR ICE to guide wire out of the RV. Assess final results.

POTENTIAL PITFALLS

Frame rate of 3D MPR on ICE is lower than that of TEE, cost of ICE catheters, lack of reimbursement for ICE.

Related Concept Videos

Imaging Studies for Cardiovascular System II:Types of Echocardiography 01:20

238

Echocardiography plays a role in assessing cardiac health and detecting heart conditions, with various types providing critical insights for diagnosis and treatment.
Types of Echocardiography
Transthoracic Echocardiography (TTE)
TTE is the most common type of echocardiogram which involves placing a transducer on the patient's chest, emitting sound waves to create heart images. TTE is invaluable for evaluating the heart's size, structure, and motion, making it particularly useful for...

Imaging Studies for Cardiovascular System I:Echocardiography 01:17

303

Cardiac imaging studies encompass a wide range of noninvasive and minimally invasive techniques designed to visualize the heart's structure and function in detail. One such technique is echocardiography, which uses high-frequency ultrasound waves to produce detailed images of the heart, known as echocardiograms.
Indications: Echocardiography is utilized to diagnose heart failure, valve disorders, and myocardial infarction. It also assesses cardiac structures' size, shape, and motion,...

Endoscopic Studies II: Thoracocentesis 01:26

223

Thoracentesis(Thoracocentesis), commonly known as pleural tap, is a medical procedure where a 22 gauge needle is inserted into the pleural space, the area between the lung and chest wall. This procedure is commonly performed to diagnose or treat various respiratory disorders.
Description
Excess pleural fluid or air may accumulate in some respiratory disorders in the thoracic cavity. To treat pleural effusion, a physician conducts thoracentesis by carefully piercing the chest wall and entering...

Ultrasound II: Endoscopic Ultrasound and FibroScan 01:25

88

Endoscopic Ultrasound (EUS) and FibroScan are valuable diagnostic tools in gastroenterology and hepatology, each with specific applications and techniques.
Endoscopic Ultrasound (EUS):

Technological Integration: EUS is a sophisticated integration of optical endoscopy and ultrasonography. The endoscope visualizes the mucosal surface directly, while the ultrasound component penetrates deeper to visualize organs and structures beyond the gastrointestinal wall.
Image Formation: The ultrasound...

Ultrasonography 01:17

4.4K

Ultrasonography is an imaging technique that uses high-frequency sound waves to visualize the body's internal structures. It is a non-invasive and safe procedure that does not involve the use of ionizing radiation, making it widely used in various medical fields. Ultrasonography is used to study heart function, blood flow in the neck or extremities, certain conditions such as gallbladder disease, and fetal growth and development.
During an ultrasonography procedure, a handheld device called...

Endoscopic Studies I: Bronchoscopy and Thoracoscopy 01:30

179

Endoscopy is a non-surgical medical technique used to examine a person's internal organs and vessels. This lesson will focus on two types of endoscopic studies: bronchoscopy and thoracoscopy.
Bronchoscopy
Description
Bronchoscopy is a procedure that involves direct visualization of the larynx, trachea, and bronchi for diagnostic and therapeutic purposes. A flexible fiber optic or rigid bronchoscope is used to carry out the procedure. The fiber-optic bronchoscope is more frequently used due...