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Echo-guided presentation of the aortic valve minimises contrast exposure in transcatheter valve recipients
Östergötlands Läns Landsting, Heart and Medicine Centre, Department of Clinical Physiology UHL.
Linköping University, Department of Medical and Health Sciences, Thoracic Surgery. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Centre, Department of Thoracic and Vascular Surgery in Östergötland.
Östergötlands Läns Landsting, Heart and Medicine Centre, Department of Thoracic and Vascular Surgery in Östergötland.
Linköping University, Department of Medical and Health Sciences, Cardiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Centre, Department of Cardiology UHL.
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2011 (English)In: Catheterization and cardiovascular interventions, ISSN 1522-1946, E-ISSN 1522-726X, Vol. 77, no 2, 272-275 p.Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES:

We have developed a method using transthoracic echocardiography in establishing optimal visualization of the aortic root, to reduce the amount of contrast medium used in each patient.

BACKGROUND:

During transcatheter aortic valve implantation, it is necessary to obtain an optimal fluoroscopic projection for deployment of the valve showing the aortic ostium with the three cusps aligned in the beam direction. This may require repeat aortic root angiograms at this stage of the procedure with a high amount of contrast medium with a risk of detrimental influence on renal function.

METHODS:

We studied the conventional way and an echo guided way to optimize visualisation of the aortic root. Echocardiography was used initially allowing easier alignment of the image intensifier with the transducer's direction.

RESULTS:

Contrast volumes, radiation/fluoroscopy exposure times, and postoperative creatinine levels were significantly less in patients having the echo-guided orientation of the optimal fluoroscopic angles compared with patients treated with the conventional approach.

CONCLUSION:

We present a user-friendly echo-guided method to facilitate fluoroscopy adjustment during transcatheter aortic valve implantation. In our series, the amounts of contrast medium and radiation have been significantly reduced, with a concomitant reduction in detrimental effects on renal function in the early postoperative phase.

Place, publisher, year, edition, pages
2011. Vol. 77, no 2, 272-275 p.
Keyword [en]
aortic valve stenosis;heart valve prosthesis;transthoracic echocardiography
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-74503DOI: 10.1002/ccd.22747PubMedID: 20824753OAI: oai:DiVA.org:liu-74503DiVA: diva2:486108
Available from: 2012-01-30 Created: 2012-01-30 Last updated: 2017-12-08

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Ahn, HenrikNielsen, Niels-ErikNylander, EvaJanerot-Sjöberg, BirgittaSandborg, MichaelWallby, Lars

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Ahn, HenrikNielsen, Niels-ErikNylander, EvaJanerot-Sjöberg, BirgittaSandborg, MichaelWallby, Lars
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Department of Clinical Physiology UHLThoracic SurgeryFaculty of Health SciencesDepartment of Thoracic and Vascular Surgery in ÖstergötlandCardiologyDepartment of Cardiology UHLClinical PhysiologyBiomedical InstrumentationThe Institute of TechnologyRadiation PhysicsDepartment of Radiation Physics UHL
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