ASE publishes recommendations for echo-guided interventions

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Physicians will be able to move away from pure surgical approaches and utilize less invasive techniques for the treatment of structural heart disease with the help of cardiovascular ultrasound technology, according to a new guideline document in the March issue of the Journal of the American Society of Echocardiography (JASE).

The use of echocardiography to guide a physician through a procedure as it is being performed has allowed physicians to treat some patients with complex conditions without open heart surgery, and has made the minimally invasive procedures to correct the conditions safer and faster, while improving the overall results for many patients.

"A major advantage of echocardiography over other advanced imaging is that echocardiography is mobile and real time. Echocardiograms can be recorded at the bedside, in the cardiovascular intensive care unit, in the emergency room--virtually any place that can accommodate a wheeled cart or even a machine the size of a laptop," said Richard E. Kerber, MD, lead author of the article. "This tremendous advantage allows for the performance of imaging immediately before, during, and after various procedures involving interventions."

The guideline document outlines each type of echocardiography study as it relates to specific procedures, and makes recommendations to help guide the selection of the right type of echocardiogram for the procedure being performed. Procedures addressed in the document include: transatrial septal catheterization, using balloons to open tight mitral valves, closing holes in the heart (atrial septal defects) with clamshell devices, guiding the placement of artificial valves to replace degenerated native valves and others.

The ASE Guideline Document, "Echocardiography-Guided Interventions" discusses all modalities of echocardiography, but emphasizes intracardiac echocardiography, which "has taken on a central role in selecting the right patients to work on, guiding the procedures as they are being performed, and monitoring their safety during the procedure. The use of imaging techniques to guide even well-established procedures enhances the efficiency and safety of these procedures," the authors wrote.

The full article is available at