Role of Imaging in Interventions on Structural Heart Disease

Mario Carminati; Mauro Agnifili; Carmelo Arcidiacono; Nedy Brambilla; Claudio Bussadori; Gianfranco Butera; Massimo Chessa; Mohammed Heles; Angelo Micheletti; Diana G Negura; Luciane Piazza; Antonio Saracino; Luca Testa; Maurizio Tusa; Francesco Bedogni

Disclosures

Expert Rev Cardiovasc Ther. 2013;11(12):1659-1676. 

In This Article

Abstract and Introduction

Abstract

Recent technological progresses have led to the development of new devices and procedures which have greatly improved the chance to effectively treat structural heart diseases in both children and adults. Interventional cardiology has been receiving fast and wide implementation as an effective alternative treatment to surgery for several congenital and acquired diseases. The advent of transcatheter valve implantation/repair techniques constitutes one of the main breakthroughs of the last decades. Such development and implementation is strictly related to a continuous progress in cardiac imaging as well. Indeed, multimodality cardiac imaging (such as X-ray, echocardiography, MRI, multidetector computed tomography) has become essential in providing accurate patient selection and in monitoring the interventional procedures in order to optimize the success rate and minimize the frequency of complications. The current article aims at reviewing the role of multimodality imaging for planning and guiding interventions in several structural heart diseases.

Introduction

Recent technological progresses have led to the development of new devices and procedures which have greatly improved the chance to effectively treat structural heart diseases in children and adult patients and, following initial encouraging results, such new techniques have received fast and wide implementation in the field of interventional cardiology.

Of note, the role of imaging has evolved to support such implementation as every procedure, from the initial planning and intraoperative monitoring to the assessment of the acute result and follow-up, requires a careful mostly non-invasive evaluation.

A large amount of literature is currently trying to determine the most appropriate imaging tool for every specific condition, however, we all experienced the need for a 'multimodality' imaging approach aiming at the integration rather than at the selection of the necessary information.

We hereby analyze the role of the different available imaging techniques (echocardiography, angiography, CT scan and magnetic resonance) and their capability to support the intervention on children and adult structural heart disease, taking into account each cardiac disease.

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