Division of Cardiology, Cardiocentro Ticino, Lugano, Switzerland.
Division of Cardiology, Cardiocentro Ticino, Lugano, Switzerland.
JACC Cardiovasc Imaging. 2014 Mar;7(3):292-308. doi: 10.1016/j.jcmg.2013.10.012.
Guidance of catheter-based procedures is performed using fluoroscopy and 2-dimensional transesophageal echocardiography (TEE). Both of these imaging modalities have significant limitations. Because of its 3-dimensional (3D) nature, 3D TEE allows visualizing the entire scenario in which catheter-based procedures take place (including long segments of catheters, tips, and the devices) in a single 3D view. Despite these undeniable advantages, 3D TEE has not yet gained wide acceptance among most interventional cardiologists and echocardiographists. One reason for this reluctance is probably the absence of standardized approaches for obtaining 3D perspectives that provide the most comprehensive information for any single step of any specific procedure. Therefore, the purpose of this review is to describe what we believe to be the most useful 3D perspectives in the following catheter-based percutaneous interventions: transseptal puncture; patent foramen ovale/atrial septal defect closure; left atrial appendage occlusion; mitral valve repair; and closure of paravalvular leaks.
基于导管的程序的指导使用荧光透视和二维经食管超声心动图（TEE）进行。这两种成像方式都有很大的局限性。由于其三维（3D）性质，3D TEE 允许在单个 3D 视图中可视化导管程序进行的整个场景（包括导管的长段、尖端和器械）。尽管有这些不可否认的优势，但 3D TEE 尚未在大多数介入心脏病学家和超声心动图医师中广泛接受。不愿意接受的原因之一可能是缺乏用于获取 3D 视角的标准化方法，这些方法为任何特定程序的任何单个步骤提供最全面的信息。因此，本综述的目的是描述我们认为在以下基于导管的经皮介入中最有用的 3D 视角：经房间隔穿刺；卵圆孔未闭/房间隔缺损封堵；左心耳封堵；二尖瓣修复；以及瓣周漏封堵。
