Intracardiac echocardiography in humans using a small-sized (6F), low frequency (12.5 MHz) ultrasound catheter. Methods, imaging planes and clinical experience

Department of Medicine, Tufts University, New England Medical Center, Boston, Massachusetts 02111.

OBJECTIVES. This study was designed to determine the clinical utility and feasibility of using 12.5-MHz ultrasound catheters for intracardiac echocardiography. BACKGROUND. Intracardiac echocardiography is a potentially useful technique of cardiac imaging and monitoring in certain settings. The feasibility of intracardiac echocardiography using 20-MHz ultrasound catheters in patients has been demonstrated. High resolution images of normal cardiac structures as well as cardiac abnormalities have been obtained. However, imaging has been limited by the shallow depth of field inherent in high frequency ultrasound imaging. METHODS. Intracardiac echocardiography with 12.5-MHz catheters was performed in eight mongrel dogs and 92 patients. Catheters were introduced percutaneously in 80 patients studied in the catheterization laboratory and directly into the heart in 12 patients in the operating room. Right heart imaging was performed in 68 patients and arterial and left heart imaging in 35 patients. RESULTS. When these catheters were introduced into the venous system, the right atrium, tricuspid valve, right ventricle, pulmonary valve and pulmonary artery were visualized. Pericardial effusion, intracardiac masses and atrial septal defects were correctly identified. The left ventricle, left atrium, mitral valve, aortic valve, aorta and coronary arteries could be imaged from the arterial circulation. Diseases identified included valvular aortic stenosis, subvalvular aortic stenosis and Kawasaki disease. Average imaging time was 10 min. No complications occurred as a result of intracardiac echocardiography. CONCLUSIONS. Intracardiac echocardiography with 12.5-MHz ultrasound catheters is safe and feasible; it also provides anatomic and physiologic information. This feasibility study provides a foundation for wider clinical use of intracardic echocardiography.

This article has been cited by other articles:

				S. T. Schafer, J. Lindemann, P. Brendt, G. Kaiser, and J. Peters Intracardiac Transvenous Echocardiography Is Superior to Both Precordial Doppler and Transesophageal Echocardiography Techniques for Detecting Venous Air Embolism and Catheter-Guided Air Aspiration Anesth. Analg., January 1, 2008; 106(1): 45 - 54. [Abstract] [Full Text] [PDF]

				A Doi, M Takagi, I Toda, M Teragaki, M Yoshiyama, K Takeuchi, and J Yoshikawa Real time quantification of low temperature radiofrequency ablation lesion size using phased array intracardiac echocardiography in the canine model: comparison of two dimensional images with pathological lesion characteristics Heart, August 1, 2003; 89(8): 923 - 927. [Abstract] [Full Text] [PDF]

				D. L. Packer, C. L. Stevens, M. G. Curley, C. J. Bruce, F. A. Miller, B. K. Khandheria, J. K. Oh, L. J. Sinak, and J. B. Seward Intracardiac phased-array imaging: methods and initial clinical experience with high resolution, under blood visualization: Initial experience with intracardiac phased-array ultrasound J. Am. Coll. Cardiol., February 6, 2002; 39(3): 509 - 516. [Abstract] [Full Text] [PDF]

				D. J. Callans, J.-F. Ren, D. Schwartzman, C. D. Gottlieb, F. A. Chaudhry, and F. E. Marchlinski Narrowing of the superior vena cava-right atrium junction during radiofrequency catheter ablation for inappropriate sinus tachycardia: analysis with intracardiac echocardiography J. Am. Coll. Cardiol., May 1, 1999; 33(6): 1667 - 1670. [Abstract] [Full Text] [PDF]

				W. G. Fisher, M. A. Pelini, and M. E. Bacon Adjunctive Intracardiac Echocardiography to Guide Slow Pathway Ablation in Human Atrioventricular Nodal Reentrant Tachycardia : Anatomic Insights Circulation, November 4, 1997; 96(9): 3021 - 3029. [Abstract] [Full Text]