Role of echocardiography for catheter-based management of valvular heart disease

摘要: Catheter-based treatment of valvular heart disease, such as transvalvular aortic valve replacement (TAVR) or mitral clip procedure, has been increasingly accepted a choice for the past several years. Such new options have changing management patients with disease drastically while socio-economic factors regarding their application need to be taken into consideration. The use echocardiography, including transesophageal echocardiography (TEE), catheter-based treatments is essential success procedures. Severe hypotension after TAVR life-threatening emergency. Rapid assessment and diagnosis in catheterization hybrid laboratory safety positive outcome. Possible diagnoses this critical situation would include severe left ventricular dysfunction due coronary obstruction, cardiac tamponade, rupture, acute and/or regurgitation, hypovolemia bleeding. Although types valves reduce para-valvular regurgitation (AR) significantly, it still important judge severity AR correctly laboratory. As TEE vital guiding monitoring entire process. Accurate identification location geometry regurgitant orifice necessary proper placement clip. Real-time 3D provides helpful en face view together end. Residual (MR) first not uncommon. Quick precise imaging residual MR (location severity) extremely interventionist place second possibly third properly. After completion stenosis also iatrogenic atrial septal defect checked by TEE. Echocardiography, especially TEE, other newer trans-catheter procedures device closure artificial valve, native replacement.