Intracardiac phased-array imaging: methods and initial clinical experience with high resolution, under blood visualization
Initial experience with intracardiac phased-array ultrasound
Douglas L. Packer, MD*,*,
Carolyn L. Stevens, RN, BSN*,
Michael G. Curley, PhD*,
Charles J. Bruce, MD*,
Fletcher A. Miller, MD*,
Bijoy K. Khandheria, MD*,
Jae K. Oh, MD*,
Lawrence J. Sinak, MD* and
James B. Seward, MD*
* Division of Cardiology, Mayo Foundation, Rochester, Minnesota, USA
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Figure 1 Right atrium (RA) at the superior vena cava/right atrial junction. Note the anterior cristal (AC) ridge and trabeculae within the right atrial appendage (RAA). 1 cm calibration markers are also shown.
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Figure 2 Color flow imaging demonstrating mild tricuspid valve insufficiency. Tricuspid insufficiency is noted as three jets of mid-range velocity (arrowheads) directed toward the imaging head. RA = right atrium; RV = right ventricle.
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Figure 3 Membranous fossa ovalis obtained at an 8.5 MHz frequency from the right atrium (RA). The color flow image shows two jets directed into the left atrium (LA) across a fenestrated atrial septal defect.
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Figure 4 Left inferior (LI) and superior (LS) pulmonary veins entering into the posterior left atrium (LA). (A) The inferior vein entering from below and immediately to the left of the superior vein. (B) A pulsed wave Doppler tracing obtained from the inferior vessel.
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Figure 5 (A) Color flow and spectral Doppler imaging of the right inferior pulmonary vein. (B) Pulsed wave Doppler traces from the orifice of the right superior pulmonary vein. Here the vein orifice is viewed "en fas."
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Figure 6 Cross-sectional view of the aortic valve (AV) leaflets seen from immediately above the tricuspid valve. The RV apex (RV), outflow tract and pulmonic valve (PV) are seen. Note the trivial pulmonic regurgitant jet (arrowheads).
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Figure 7 (A) Long-axis view of the left ventricle (LV) obtained from within the right ventricular outflow tract. Note the mitral valve (MV), chamber dilation, papillary muscles (PM) and an eccentric jet of mild mitral insufficiency. Also present is a small loculated posterior pericardial effusion (PE). (B) Catheter positioned across the tricuspid valve (TV) into the outflow tract used to obtain Figures 7 and 8. PV = pulmonic valve.
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Figure 8 Short-axis left ventricular (LV) view at the level of the anterior (arrowheads) and posterior (open arrowheads) mitral valve leaflets. This image is obtained across the intraventricular septum with the catheter tip positioned in the right ventricular outflow tract.
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Figure 9 Multipolar His bundle recording electrode catheter is seen coursing from the right atrium (RA) to the medial aspect of the tricuspid valve (arrowheads). Ao = aortic root; RV = right ventricle.
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