Usefulness of Micro-TEE imaging for structural heart disease procedures

In recent years there has been a strong increase in the number of innovative
percutaneous cardiac interventions for the treatment of patients with
structural heart disease. These interventions allows the treatment of patients
who previously were at too high risk for a surgical operation.
Echocardiography using TEE or ICE imaging are crucial for guiding these
procedures. Recently, a microTEE probe for transesophageal imaging in children
has become available.
This study is evaluating whether the microTEE can be used in place of the
current TEE probe, or intra-cardiac ultrasound catheters (ICE) in adult with a
structural heart disease.
The use of the microTEE probe may have the following advantages compared to the
current TEE probe or ICE:
- The MicroTEE probe is much smaller than the current TEE probe which is less
invasive and risks to patient are lower.
- Less invasive than intracardiac echo because venapuncture is no longer
necessary
- Because the probe smaller / less invasive, it is expected that the probe is
better tollerated and general anaesthesia might not be necessary anymore with
less risks for the patient and cost-saving.
- The MicroTEE can be reused which is costsaving compared to the disposable
catheters used in ICE.

This study is aimed at evaluate whether the microTEE can be used in stead of
the current TEE probe, or intracardiac ultrasound catheters (ICE) in adults
with a structural heart disease.
The aim of the study is to compare image quality, the workflow and the ability
to visualize the probe using the MicroTEE various cardiac structures and to
compare it with the current standard (TEE or ICE). Anonimized images will be
saved to use for a prototype software for the fusion of X-ray and ultrasound
images.

Patients who are scheduled to undergo a procedure concerning structural heart
disease will be contacted if prior to the procedure additional recordings with
the MicroTEE probe can be made. After this procedure will be carried out with
the guidance of TEE or ICE in the usual way

Additional recordings with MicroTEE probe prior to the scheduled procedure
which is currently guided by TEE or ICE will be made

Minimal burden and risk for the patient. Prior to the study only a few images
with MicroTEE probe will be made before the initiation of the planned procedure
which is currenlty guided by TEE or ICE imaging. Patients are in the majority
of cases under general anesthesia so there is no burden in these patients. In
patients who do not receive general anesthesia we will examine if the microTEE
probe is well tolerated.