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Eur Heart J Imaging Methods Pract
Eur Heart J Imaging Methods Pract
ehjimp
European Heart Journal. Imaging Methods and Practice
2755-9637
Oxford University Press UK

10.1093/ehjimp/qyae088
qyae088
Image Focus
AcademicSubjects/MED00010
AcademicSubjects/MED00160
AcademicSubjects/MED00200
AcademicSubjects/MED00870
Eurheartj/31
Eurheartj/35
Eurheartj/36
Eurheartj/39
Eurheartj/41
Less is more: X-ray–TEE fusion with a new mini probe
https://orcid.org/0000-0002-3151-320X
Fernández-Golfín Covadonga Cardiology Department, Ramón y Cajal University Hospital, Carretera de Colmenar Km 9,100, 28034 Madrid, Spain
CIBERCV, Centro de Investigación Biomédica en Red Enfermedades Cardiovaculares, Av. Monforte de Lemos, 3-5, 28029 Madrid, Spain

García-Martín Ana Cardiology Department, Ramón y Cajal University Hospital, Carretera de Colmenar Km 9,100, 28034 Madrid, Spain

Carrión Irene Cardiology Department, Ramón y Cajal University Hospital, Carretera de Colmenar Km 9,100, 28034 Madrid, Spain

Salido Tahoces Luisa Cardiology Department, Ramón y Cajal University Hospital, Carretera de Colmenar Km 9,100, 28034 Madrid, Spain
CIBERCV, Centro de Investigación Biomédica en Red Enfermedades Cardiovaculares, Av. Monforte de Lemos, 3-5, 28029 Madrid, Spain

Zamorano Jose Luis Cardiology Department, Ramón y Cajal University Hospital, Carretera de Colmenar Km 9,100, 28034 Madrid, Spain
CIBERCV, Centro de Investigación Biomédica en Red Enfermedades Cardiovaculares, Av. Monforte de Lemos, 3-5, 28029 Madrid, Spain

Corresponding author. E-mail: covagolfin@yahoo.es
7 2024
24 9 2024
24 9 2024
2 3 qyae08823 7 2024
17 8 2024
24 9 2024
© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology.
2024
https://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com

fusion imaging
interventional image
mini-TEE probe
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pmc

Transoesophageal echocardiography (TEE) is essential during most percutaneous cardiac interventions. Traditional TEE probes with advanced 3D and X-ray–echo fusion tools are commonly used. However, full anaesthesia is required, and TEE-derived complications are not uncommon, particularly in a fragile population with multiple comorbidities and advanced age. Smaller TEE probes have been developed to avoid the need for anaesthesia and reduce oesophageal complications. However, these so-called micro probes lack comprehensive imaging capabilities. Recent technological advancements have addressed these limitations, and for the first time, we present high-quality 3D and X-ray–echo fusion images during paravalvular leak closure, acquired with the mini X11-4t probe (Philips Medical Systems, Andover, Massachusetts). This type of probe, with full imaging capabilities, offers a new option, particularly for higher-risk patients undergoing simpler procedures, avoiding general anaesthesia, and other complications. (Panels A and B) 3D image and GlassVue of the paravalvular septal leak (arrow). (Panel C, Supplementary data online, Videos S1 and S2) Echonavigator screen: right, 2D colour X-plane image with leak position marked in purple; left, 2D colour X-ray–echo fusion image, the marker is seen to guide crossing of the wire through the leak. (Panel D, Supplementary data online, Video S3) Right, 3D images with 2D multiplane reconstructions (MPR); left, 3D echo–X-ray fusion images with the wire already in the left ventricle. (Panel E) Right, 3D image of the mitral prosthesis with 2D MPR reconstructions and leak marked in green; left, X-ray–3D echo fusion image with the leak marked and the catheter already through the defect. (Panel F) 2D colour X-ray–echo fusion image (left) during device deployment along with 2D colour images (right). (Panel G) Colour 2D residual leak after closure.

Supplementary data

Supplementary data are available at European Heart Journal - Imaging Methods and Practice online.

Conflict of interest: None declared.

Data availability: The data underlying this article are available in the article and its online Supplementary material.

Lead author biography

Covadonga Fernandez-Golfín works in Ramón y Cajal cardiac Imaging Unit in Madrid. She is the Head of the Non-invasive Imaging Unit in the Cardiology department. She has more than 15 years of experience in cardiac imaging including echocardiography, CMR, and cardiac CT. She is also involved in structural intervention imaging. She has more than 100 articles published regarding cardiac imaging and is involved in national and educational activities.

Supplementary Material

qyae088_Supplementary_Data
