Pub Date : 2021-06-01DOI: 10.1093/MED/9780198849353.003.0051
A. Evangelista, G. Teixidó-Tura
Echocardiography plays an important role in the diagnosis and follow-up of aortic diseases. Evaluation of the aorta is a routine part of the echocardiographic examination. Transthoracic echocardiography (TTE) is an excellent modality for imaging the aortic proximal ascending aorta, which is important in the diagnosis and follow-up of aorta aneurysms. Transoesophageal echocardiography (TEE) overcomes the limitations of TTE in thoracic aorta assessment. Although TEE is the technique of choice in the diagnosis of aortic dissection, TTE may be used as the initial modality in the emergency setting. Intimal flap in proximal ascending aorta, pericardial effusion/tamponade, and left ventricular function can be easily visualized by TTE. However, a negative TTE does not rule out aortic dissection and other imaging techniques must be considered. TEE should define entry tear size and location, mechanisms and severity of aortic regurgitation, and true lumen compression. TEE is essential in selecting and monitoring surgical and endovascular treatment and in detecting possible complications.
{"title":"The role of echocardiography","authors":"A. Evangelista, G. Teixidó-Tura","doi":"10.1093/MED/9780198849353.003.0051","DOIUrl":"https://doi.org/10.1093/MED/9780198849353.003.0051","url":null,"abstract":"Echocardiography plays an important role in the diagnosis and follow-up of aortic diseases. Evaluation of the aorta is a routine part of the echocardiographic examination. Transthoracic echocardiography (TTE) is an excellent modality for imaging the aortic proximal ascending aorta, which is important in the diagnosis and follow-up of aorta aneurysms. Transoesophageal echocardiography (TEE) overcomes the limitations of TTE in thoracic aorta assessment. Although TEE is the technique of choice in the diagnosis of aortic dissection, TTE may be used as the initial modality in the emergency setting. Intimal flap in proximal ascending aorta, pericardial effusion/tamponade, and left ventricular function can be easily visualized by TTE. However, a negative TTE does not rule out aortic dissection and other imaging techniques must be considered. TEE should define entry tear size and location, mechanisms and severity of aortic regurgitation, and true lumen compression. TEE is essential in selecting and monitoring surgical and endovascular treatment and in detecting possible complications.","PeriodicalId":259304,"journal":{"name":"The ESC Textbook of Cardiovascular Imaging","volume":"122 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114644998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-06-01DOI: 10.1093/MED/9780198849353.003.0037
L. Pierard, P. Gargiulo, P. Perrone-filardi, Bernhard Gerber, J. Selvanayagam
Ischaemic left ventricular (LV) dysfunction due to coronary artery disease (CAD) is steadily increasing as a consequence of the ageing of the population and of improved survival of patients with acute coronary syndromes and currently represents the first cause of heart failure (HF). Myocardial function is dependent on blood supply, as anaerobic reserve is minimum due to a nearly maximal arteriovenous oxygen extraction. At rest, myocardial blood flow remains normal even in the presence of severe coronary artery stenosis (up to 85% diameter stenosis) by coronary autoregulation. In the presence of transstenotic pressure gradient due to epicardial coronary stenosis, arteriolar dilatation maintains normal myocardial flow at rest but with a progressive reduction in flow reserve. When arteriolar dilatation is maximal, autoregulation is exhausted and myocardial ischaemia develops. The limit of autoregulation depends on myocardial oxygen demand and is influenced by heart rate. Tachycardia increases oxygen demand and supply is reduced because of a decreased diastolic perfusion time. In the presence of acute ischaemia, there is a close relation between subendocardial perfusion and transmural function. Indeed, the contribution of subendocardium to myocardial thickening largely exceeds the contribution of the subepicardium. Akinesia can therefore result from subendocardial ischaemia and transmural ischaemia is not necessary. This chapter looks at how viability of the different techniques for treating myocardial dysfunction is assessed.
{"title":"Assessment of viability","authors":"L. Pierard, P. Gargiulo, P. Perrone-filardi, Bernhard Gerber, J. Selvanayagam","doi":"10.1093/MED/9780198849353.003.0037","DOIUrl":"https://doi.org/10.1093/MED/9780198849353.003.0037","url":null,"abstract":"Ischaemic left ventricular (LV) dysfunction due to coronary artery disease (CAD) is steadily increasing as a consequence of the ageing of the population and of improved survival of patients with acute coronary syndromes and currently represents the first cause of heart failure (HF). Myocardial function is dependent on blood supply, as anaerobic reserve is minimum due to a nearly maximal arteriovenous oxygen extraction. At rest, myocardial blood flow remains normal even in the presence of severe coronary artery stenosis (up to 85% diameter stenosis) by coronary autoregulation. In the presence of transstenotic pressure gradient due to epicardial coronary stenosis, arteriolar dilatation maintains normal myocardial flow at rest but with a progressive reduction in flow reserve. When arteriolar dilatation is maximal, autoregulation is exhausted and myocardial ischaemia develops. The limit of autoregulation depends on myocardial oxygen demand and is influenced by heart rate. Tachycardia increases oxygen demand and supply is reduced because of a decreased diastolic perfusion time. In the presence of acute ischaemia, there is a close relation between subendocardial perfusion and transmural function. Indeed, the contribution of subendocardium to myocardial thickening largely exceeds the contribution of the subepicardium. Akinesia can therefore result from subendocardial ischaemia and transmural ischaemia is not necessary. This chapter looks at how viability of the different techniques for treating myocardial dysfunction is assessed.","PeriodicalId":259304,"journal":{"name":"The ESC Textbook of Cardiovascular Imaging","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116635502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-06-01DOI: 10.1093/MED/9780198849353.003.0014
F. Peters, E. Brochet
Mitral stenosis is an important valvular lesion that when encountered both in the developing world and the developed world requires accurate assessment. The mitral valve area is the key parameter that should be used to assess severity. Morphological assessment of the entire valve apparatus is required to identify rheumatic versus non-rheumatic aetiology as well the subgroup of patients who may benefit from percutaneous mitral commisurotomy. Three-dimensional transthoracic and transoesophageal echocardiography provide additive qualitative and quantitative data to the aforementioned key imaging requirements. Tomographic imaging (CT/MRI) are mainly utilized when echocardiography is not feasible. Imaging techniques are vital to aid diagnosis and explore therapeutic options in degenerative mitral stenosis but require further refinement with regard to accuracy of diagnosis and selection of optimal quantitative techniques.
{"title":"Mitral valve stenosis","authors":"F. Peters, E. Brochet","doi":"10.1093/MED/9780198849353.003.0014","DOIUrl":"https://doi.org/10.1093/MED/9780198849353.003.0014","url":null,"abstract":"Mitral stenosis is an important valvular lesion that when encountered both in the developing world and the developed world requires accurate assessment. The mitral valve area is the key parameter that should be used to assess severity. Morphological assessment of the entire valve apparatus is required to identify rheumatic versus non-rheumatic aetiology as well the subgroup of patients who may benefit from percutaneous mitral commisurotomy. Three-dimensional transthoracic and transoesophageal echocardiography provide additive qualitative and quantitative data to the aforementioned key imaging requirements. Tomographic imaging (CT/MRI) are mainly utilized when echocardiography is not feasible. Imaging techniques are vital to aid diagnosis and explore therapeutic options in degenerative mitral stenosis but require further refinement with regard to accuracy of diagnosis and selection of optimal quantitative techniques.","PeriodicalId":259304,"journal":{"name":"The ESC Textbook of Cardiovascular Imaging","volume":"38 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133360902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-06-01DOI: 10.1093/MED/9780198849353.003.0015
Daniel-Edgardo Muñoz, K. Yiangou, J. Zamorano
The prevalence of mitral regurgitation (MR) is increasing in Western countries, which results in making it the second most frequent valvular heart disease requiring surgery. MR can be classified as primary (organic) or secondary (functional). Causes of primary MR consist of leaflet lesions, either degenerative changes (Barlow’s disease, fibroelastic degeneration, and annular calcification), rheumatic disease, or infective endocarditis. Causes of secondary MR consist of those that produce geometrical distortion of the subvalvular apparatus due to dilatation and remodelling of the left ventricle such as ischaemic heart disease and cardiomyopathies. The implementation of mitral valve repair as well as the rise of new transcatheter techniques, provided that are performed in experienced, high volume centres with the contribution of a valvular heart team, have impressively changed the prognosis of patients with severe MR. This has set new frontiers in the management of MR and has upgraded the role of imaging, creating new responsibilities, since its presence in every step of the procedure either preoperatively (quantification of MR, determination of the underlying mechanisms, investigation of reparability, determination of prognosis) or intra- and postoperatively, has been declared as fundamental.
{"title":"Mitral valve regurgitation","authors":"Daniel-Edgardo Muñoz, K. Yiangou, J. Zamorano","doi":"10.1093/MED/9780198849353.003.0015","DOIUrl":"https://doi.org/10.1093/MED/9780198849353.003.0015","url":null,"abstract":"The prevalence of mitral regurgitation (MR) is increasing in Western countries, which results in making it the second most frequent valvular heart disease requiring surgery. MR can be classified as primary (organic) or secondary (functional). Causes of primary MR consist of leaflet lesions, either degenerative changes (Barlow’s disease, fibroelastic degeneration, and annular calcification), rheumatic disease, or infective endocarditis. Causes of secondary MR consist of those that produce geometrical distortion of the subvalvular apparatus due to dilatation and remodelling of the left ventricle such as ischaemic heart disease and cardiomyopathies. The implementation of mitral valve repair as well as the rise of new transcatheter techniques, provided that are performed in experienced, high volume centres with the contribution of a valvular heart team, have impressively changed the prognosis of patients with severe MR. This has set new frontiers in the management of MR and has upgraded the role of imaging, creating new responsibilities, since its presence in every step of the procedure either preoperatively (quantification of MR, determination of the underlying mechanisms, investigation of reparability, determination of prognosis) or intra- and postoperatively, has been declared as fundamental.","PeriodicalId":259304,"journal":{"name":"The ESC Textbook of Cardiovascular Imaging","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128102185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-06-01DOI: 10.1093/MED/9780198849353.003.0016
D. Muraru, E. Sade
Right heart valves have gained significant interest in the context of a plethora of new emerging percutaneous transcatheter interventions for treating tricuspid and pulmonary valve diseases. Multimodality imaging is pivotal for patient diagnosis, management, and prognosis, as well as for planning interventional and surgical valve procedures. Echocardiography is the primary imaging modality for initial diagnosis and longitudinal follow-up of patients with right-sided valvular heart disease. Cardiovascular magnetic resonance has emerged as a complementary or alternative modality for providing diagnostic information on the tricuspid and pulmonary valve anatomy, and particularly on the pulmonary artery and the consequences on the right ventricle. This chapter highlights the current use of various imaging modalities for the state-of-the-art assessment of right-sided valvular heart diseases, with emphasis on the main clinical indications, as well as on the strengths and limitations of each modality.
{"title":"Tricuspid and pulmonary valve disease","authors":"D. Muraru, E. Sade","doi":"10.1093/MED/9780198849353.003.0016","DOIUrl":"https://doi.org/10.1093/MED/9780198849353.003.0016","url":null,"abstract":"Right heart valves have gained significant interest in the context of a plethora of new emerging percutaneous transcatheter interventions for treating tricuspid and pulmonary valve diseases. Multimodality imaging is pivotal for patient diagnosis, management, and prognosis, as well as for planning interventional and surgical valve procedures. Echocardiography is the primary imaging modality for initial diagnosis and longitudinal follow-up of patients with right-sided valvular heart disease. Cardiovascular magnetic resonance has emerged as a complementary or alternative modality for providing diagnostic information on the tricuspid and pulmonary valve anatomy, and particularly on the pulmonary artery and the consequences on the right ventricle. This chapter highlights the current use of various imaging modalities for the state-of-the-art assessment of right-sided valvular heart diseases, with emphasis on the main clinical indications, as well as on the strengths and limitations of each modality.","PeriodicalId":259304,"journal":{"name":"The ESC Textbook of Cardiovascular Imaging","volume":"36 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115274711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-06-01DOI: 10.1093/MED/9780198849353.003.0025
R. Hahn
Given the high prevalence of significant functional tricuspid regurgitation (TR) in a number of disease states, as well as the impact of TR on mortality, interest has grown in refining the diagnosis and treatment, with hopes of improving outcomes. Surgical intervention has been associated with high mortality and limited improvement in mortality resulting in a need for less invasive alternatives. The current chapter reviews the new percutaneous options for treatment of TR by looking at the pertinent surgical literature, reviewing the relevant anatomic, discussing the strengths and pitfalls of imaging this complex disease process and finally reviewing important device design that may influence device choice.
{"title":"Transcatheter tricuspid valve repair/replacement","authors":"R. Hahn","doi":"10.1093/MED/9780198849353.003.0025","DOIUrl":"https://doi.org/10.1093/MED/9780198849353.003.0025","url":null,"abstract":"Given the high prevalence of significant functional tricuspid regurgitation (TR) in a number of disease states, as well as the impact of TR on mortality, interest has grown in refining the diagnosis and treatment, with hopes of improving outcomes. Surgical intervention has been associated with high mortality and limited improvement in mortality resulting in a need for less invasive alternatives. The current chapter reviews the new percutaneous options for treatment of TR by looking at the pertinent surgical literature, reviewing the relevant anatomic, discussing the strengths and pitfalls of imaging this complex disease process and finally reviewing important device design that may influence device choice.","PeriodicalId":259304,"journal":{"name":"The ESC Textbook of Cardiovascular Imaging","volume":"43 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125428121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-06-01DOI: 10.1093/MED/9780198849353.003.0013
J. Magne, P. Lancellotti
Transthoracic echocardiography (TTE) is the first-line imaging tool to assess aortic valve (AV), aorta, and subsequent aortic regurgitation (AR). The parasternal long-axis view is classically used to measure the left outflow tract, the aortic annulus, and the aortic sinuses. Leaflet thickening and morphology can be visualized from this window as well as from the parasternal short-axis view and the apical five-chamber view. Nevertheless, 2D TTE may be limited and not enabling correct identification of the anatomy and causes of AR. In this situation, 3D echocardiography and cardiac magnetic resonance (CMR) could provide better delineation of the AV morphology. In some cases, transoesophageal echocardiography (TOE) could be required, more particularly for assessing the aortic root dimensions.
{"title":"Aortic valve regurgitation","authors":"J. Magne, P. Lancellotti","doi":"10.1093/MED/9780198849353.003.0013","DOIUrl":"https://doi.org/10.1093/MED/9780198849353.003.0013","url":null,"abstract":"Transthoracic echocardiography (TTE) is the first-line imaging tool to assess aortic valve (AV), aorta, and subsequent aortic regurgitation (AR). The parasternal long-axis view is classically used to measure the left outflow tract, the aortic annulus, and the aortic sinuses. Leaflet thickening and morphology can be visualized from this window as well as from the parasternal short-axis view and the apical five-chamber view. Nevertheless, 2D TTE may be limited and not enabling correct identification of the anatomy and causes of AR. In this situation, 3D echocardiography and cardiac magnetic resonance (CMR) could provide better delineation of the AV morphology. In some cases, transoesophageal echocardiography (TOE) could be required, more particularly for assessing the aortic root dimensions.","PeriodicalId":259304,"journal":{"name":"The ESC Textbook of Cardiovascular Imaging","volume":"48 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127875333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-06-01DOI: 10.1093/MED/9780198849353.003.0047
A. Klein, B. Cosyns, A. Schenone
Pericardial effusion (Peff) is a commonly encountered findings in clinical practice. It is usually asymptomatic, but can present as a life-threatening condition when cardiac tamponade ensues. The use of multimodality cardiac imaging has emerged as a crucial tool in the early detection and characterization of Peff and cardiac tamponade allowing prompt and effective treatment. Transthoracic echocardiography (TTE) is first-line imaging technique in the evaluation for Peff and cardiac tamponade. They key echocardiographic findings supporting cardiac tamponade include the presence of (1) cardiac chambers collapse; (2) an exaggerated ventricular interdependence; and (3) plethoric inferior vena cava (IVC). Advance cardiac imaging including transoesophageal echocardiography, cardiac CT, and cardiac MRI are reserved for complex cases with high suspicion for focal effusion or tamponade when TTE is unrevealing. Medical treatment of underlying cause is recommended for effusion without haemodynamic compromise, while emergent drainage is warranted when in cardiac tamponade.
{"title":"Pericardial effusion and cardiac tamponade","authors":"A. Klein, B. Cosyns, A. Schenone","doi":"10.1093/MED/9780198849353.003.0047","DOIUrl":"https://doi.org/10.1093/MED/9780198849353.003.0047","url":null,"abstract":"Pericardial effusion (Peff) is a commonly encountered findings in clinical practice. It is usually asymptomatic, but can present as a life-threatening condition when cardiac tamponade ensues. The use of multimodality cardiac imaging has emerged as a crucial tool in the early detection and characterization of Peff and cardiac tamponade allowing prompt and effective treatment. Transthoracic echocardiography (TTE) is first-line imaging technique in the evaluation for Peff and cardiac tamponade. They key echocardiographic findings supporting cardiac tamponade include the presence of (1) cardiac chambers collapse; (2) an exaggerated ventricular interdependence; and (3) plethoric inferior vena cava (IVC). Advance cardiac imaging including transoesophageal echocardiography, cardiac CT, and cardiac MRI are reserved for complex cases with high suspicion for focal effusion or tamponade when TTE is unrevealing. Medical treatment of underlying cause is recommended for effusion without haemodynamic compromise, while emergent drainage is warranted when in cardiac tamponade.","PeriodicalId":259304,"journal":{"name":"The ESC Textbook of Cardiovascular Imaging","volume":"69 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116990311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-06-01DOI: 10.1093/MED/9780198849353.003.0023
A. Ng, V. Delgado, J. Bax
Transcatheter aortic valve implantation (TAVI) is an established therapy for patients with symptomatic severe aortic stenosis and contraindications for surgical aortic valve replacement or with intermediate and high operative risk in whom the heart team considers that TAVI is the best therapeutic option. Accurate patient selection strongly relates on multimodality imaging consisting mostly of the combination of transthoracic echocardiography and computed tomography. To guide the procedure, fluoroscopy is the mainstay imaging modality. In the follow-up of the patients, transthoracic echocardiography and computed tomography are again the main imaging modalities to use. Cardiovascular magnetic resonance and nuclear imaging have a minimal role in this area.
{"title":"Transcatheter aortic valve implantation","authors":"A. Ng, V. Delgado, J. Bax","doi":"10.1093/MED/9780198849353.003.0023","DOIUrl":"https://doi.org/10.1093/MED/9780198849353.003.0023","url":null,"abstract":"Transcatheter aortic valve implantation (TAVI) is an established therapy for patients with symptomatic severe aortic stenosis and contraindications for surgical aortic valve replacement or with intermediate and high operative risk in whom the heart team considers that TAVI is the best therapeutic option. Accurate patient selection strongly relates on multimodality imaging consisting mostly of the combination of transthoracic echocardiography and computed tomography. To guide the procedure, fluoroscopy is the mainstay imaging modality. In the follow-up of the patients, transthoracic echocardiography and computed tomography are again the main imaging modalities to use. Cardiovascular magnetic resonance and nuclear imaging have a minimal role in this area.","PeriodicalId":259304,"journal":{"name":"The ESC Textbook of Cardiovascular Imaging","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116704263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-06-01DOI: 10.1093/MED/9780198849353.003.0026
K. Pushparajah, A. Frigiola
Right ventricular outflow tract dysfunction is the most frequent residual lesion following repair of various congenital heart diseases and can be characterized by predominant pulmonary valve stenosis, regurgitation, or a combination of both lesions. The need to replace the malfunctioning pulmonary valve in order to avoid detrimental effects on right ventricular function is widely recognized. While a surgical approach was the only possible option until less than two decades ago, advances in the medical field have made it possible to replace such valves percutaneously in selected patients, with favourable anatomy, and with comparably good results. In more recent years, further developments of the percutaneous pulmonary valve design and technology have allowed an increasing number of patients to be suitable for this preferred approach due to the less invasive nature and quicker recovery time.
{"title":"Transcatheter pulmonic valve replacement","authors":"K. Pushparajah, A. Frigiola","doi":"10.1093/MED/9780198849353.003.0026","DOIUrl":"https://doi.org/10.1093/MED/9780198849353.003.0026","url":null,"abstract":"Right ventricular outflow tract dysfunction is the most frequent residual lesion following repair of various congenital heart diseases and can be characterized by predominant pulmonary valve stenosis, regurgitation, or a combination of both lesions. The need to replace the malfunctioning pulmonary valve in order to avoid detrimental effects on right ventricular function is widely recognized. While a surgical approach was the only possible option until less than two decades ago, advances in the medical field have made it possible to replace such valves percutaneously in selected patients, with favourable anatomy, and with comparably good results. In more recent years, further developments of the percutaneous pulmonary valve design and technology have allowed an increasing number of patients to be suitable for this preferred approach due to the less invasive nature and quicker recovery time.","PeriodicalId":259304,"journal":{"name":"The ESC Textbook of Cardiovascular Imaging","volume":"42 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128071685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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