Ultrasound System Visualizes Complete Blood Flow during Interventional Heart Valve Procedures

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

With this technology, physicians can capture a more anatomically authentic view of the heart and dynamic blood flow in one view during interventional valve procedures, even in patients with electrocardiogram (ECG) abnormalities. This helps them to make faster and more effective critical decisions.

During 3D TEE imaging, the physician guides 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 properly to let through sufficient blood, a valve procedure may be needed to repair or replace the valve with an artificial one.

TEE is used to guide positioning of devices such as MitraClips and artificial valves during cardiac interventions to correct valve dysfunction. Current imaging technology with 3D TEE require stitching (the fusion of multiple heartbeats) to form a complete image of heart function and blood flow. This gated acquisition eliminates nearly 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 Siemens Healthcare (Erlangen, Germany) new 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 three-dimensional (3D) images of the heart, 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 repaired or replaced valve is working properly, potentially reducing the need for a secondary intervention to correct any remaining regurgitation.

“Volume color Doppler is extremely important,” stated 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.”

Siemens has also developed the Acuson SC2000 Prime is eSie valves analysis package, which is an 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 rapidly and simply 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,” commented 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 previous versions of the Acuson SC2000 system.

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