Ultrasound Technology Visualizes Entire Blood Flow During Valve Procedures

A new cardiovascular imaging system provides live, full-volume color Doppler ultrasound imaging of heart valve anatomy and blood flow using a new true volume, three-dimensional (3D) transesophageal echo (TEE) probe.

With this technology, physicians can gather a more anatomically accurate view of the heart and dynamic blood flow in one view during interventional valve procedures, even in patients with electrocardiogram (ECG) abnormalities, helping clinicians to make more rapid and effective crucial decisions. Additionally, new automated valve analysis software provides precise valve measurements within seconds to support heart interventions.

During 3D TEE imaging, clinicians guide a flexible probe into the esophagus to acquire close-range, detailed images of the heart to evaluate valve function. When a dysfunctional valve leaks blood back into the heart chambers (known as regurgitation) or does not open effectively to let through enough blood, a valve procedure may be necessary to repair or replace the valve with a synthetic one.

Siemens Healthcare (Erlangen, Germany) presented the new Prime edition of its Acuson SC2000 ultrasound system at the annual congress of the European Society of Cardiology (ESC), held August 2014 in Barcelona (Spain).

TEE is used to guide placement of devices such as mitraclips and artificial valves during cardiac interventions to correct valve dysfunction. Current methods of imaging with 3D TEE technology require stitching (the fusion of multiple heartbeats) to form a complete image of heart function and blood flow. This gated acquisition eliminates almost all patients with any ECG abnormalities and frequently results in image artifacts, which may skew results. However, the new Z6Ms true volume TEE probe on the Acuson SC2000 Prime is the first Siemens transducer to use true volume 3D TEE with 90° x 90° real-time acquisition and volume color Doppler, enabling full 3D images of the heart, in every heartbeat without stitching.

By eliminating the need for multiple beats to form an image and adding volume color Doppler capabilities, the Z6Ms true volume TEE probe allows the surgeon to visualize and assess blood flow in real-time during a procedure to make sure the replaced or repaired valve is working effectively, potentially decreased the need for a secondary intervention to correct any residual regurgitation.

“Volume color Doppler is extremely important,” says Dr. Lissa Sugeng, associate professor of medicine at Yale University (New Haven, CT, USA). “With Siemens’ new volume acquisition, I can see the entire valve, locate the regurgitant jet, and assess the size of the orifice very quickly so that we can continue with the procedure.”

In addition, introduced for the first time on the Acuson SC2000 Prime is eSie Valves advanced analysis package, automated software to measure heart valves during cardiac procedures. While standard quantification software takes several minutes to provide measurements of heart valves, eSie Valves provides automated measurements for the aortic and mitral valves in seconds. This quantitative information allows physicians to quickly and easily evaluate valvular anatomy and physiology, which aids in device sizing and surgical repair.

“We’re extremely proud of what the Acuson SC2000 Prime enables physicians to do in the detection and treatment of valvular disease,” stated Dr. Jeffrey Bundy, CEO, Siemens ultrasound. “We are aiming to provide tools with standard-setting performance and workflow, equipping physicians to focus on their patients and explore new and more efficacious procedures.”

The new PRIME technologies, including the Z6Ms true volume TEE transducer and the eSie Valves package, are also available as an upgrade for users of earlier versions of the Acuson SC2000 system.

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