Loghin Catalin, Loghin Andrei
Cardiology Division, UTHealth McGovern Medical School, Houston, TX, USA.
Ann Cardiothorac Surg. 2018 Nov;7(6):799-811. doi: 10.21037/acs.2018.09.07.
As minimally invasive cardiovascular procedures gain popularity, novel transcatheter mitral valve repair devices continue to emerge. The success of these technologies is critically dependent on high quality imaging performed at all stages: patient selection, intervention planning, intraprocedural guidance, monitoring complications and follow-up. We present an overview of specific imaging requirements and challenges applicable to mitral valve interventional techniques. Modern valve imaging is multimodal and primarily combines echocardiography and computed tomography (CT). Echocardiography remains the gold standard for detailed anatomic imaging, complete hemodynamic characterization and real-time guidance and evaluation of procedural success. CT is indispensable for mitral annulus (MA) imaging and in predicting left ventricular outflow tract (LVOT) obstruction post transcutaneous mitral valve replacement (TMVR). 3D modeling, fusion imaging and automated image analysis may further contribute to the evolutionary transformation of valvular heart imaging.
随着微创心血管手术越来越受欢迎,新型经导管二尖瓣修复装置不断涌现。这些技术的成功严重依赖于在各个阶段进行的高质量成像:患者选择、干预计划、术中指导、并发症监测和随访。我们概述了适用于二尖瓣介入技术的特定成像要求和挑战。现代瓣膜成像具有多模态性,主要将超声心动图和计算机断层扫描(CT)结合起来。超声心动图仍然是详细解剖成像、完整血流动力学特征分析以及手术成功的实时指导和评估的金标准。CT对于二尖瓣环(MA)成像以及预测经皮二尖瓣置换术(TMVR)后左心室流出道(LVOT)梗阻必不可少。三维建模、融合成像和自动图像分析可能会进一步推动心脏瓣膜成像的革命性变革。