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echocardiography in Transcatheter Aortic valve implantation and Mitral valve Clip
Robert J. Siegel,Huai Luo 대한내과학회 2012 The Korean Journal of Internal Medicine Vol.27 No.3
Transcatheter aortic valve implantation and transcatheter mitral valve repair (MitraClip) procedures have been performed worldwide. In this paper, we review the use of two-dimensional and three-dimensional transesophageal echo for guiding transcatheter aortic valve replacement and mitral valve repair.
혈관내 초음파 영상에 의한 형태 및 조직병리 소견 평가
채장성(Jang Seong Chae),최규보(Kyu Bo Choi),(Robert J . Siegel) 대한내과학회 1992 대한내과학회지 Vol.43 No.1
N/A Background: To evaluate geometric accuracy of intravascular ultrasound and histopathologic validation of ultrasound and angioscopy we studied postmortem human arterial segments and phantoms in vitro. Method: We used 7 to 9 French fiberoptic angioscopes and 30 MHz intravascular ultrasound imaging catheter. We assessed the area and wall thickness on 9 phantom vessels and 12 arteries with different imaging media and 30 angle of incidence. To evaluate histopathologic validation of ultrasound and angioscopy, the images of 12 normal and 55 abnormal (stable atheroma, disrupted atheroma and thrombi) vessels were compared with histology. Results: Geometric accuracy: The measured area were smaller in blood (7.2-7.6%) and gel (10,8-13.6%) than that of saline. A 30 angle of incidence resulted in 14.2%-16.3% increase in lumen area and 10,6% increase in wall thickness. Ultrasonic wall thickness of human vessels correlated closely with the actual measured thickness (r=0,93). Histopatholgic validation: the sensitivity specifictiy and accuracy of both method were greater than 96% in normal vessel and 90% in stable atheroma. For normal vessel predictive value was better for angioscopy than for ultrasound. For stable atheroma the predictive value were 77%. for angioscopy and 78% for ultrasound due to classification of disrupted atheroma to stable atheroma. For thrombus detection sensitivity was 62% for ultra- sound due to false negative interpretation of lamina clots and atheroma in vessel. Conclusion: With ultrasound measurement, lumen area and wall thickness were accurate when the catheter placement was coaxial. For histopathologic validation, angioscopy and ultrasound images had significant agreement with the results obtained from histology.