ECHO 2013 / Interventional Echocardiography

Transcatheter

Valve in

Bioprosthetic

Surgical Valve

•82 yo male

•Severe MS

•s/p tMVR 2006 (31 mm)

•1 CABG 2006 (SVG LCx)

•Severe pulm hypertension +RV

MVR Internal Dimension = 23 mm

Intra-procedural Imaging

Issues Unique to Structural Disease

Role of adjunctive imaging and pre-procedural assessment in treating structural heart disease.

CT/MRI

TTE/TEE (2D/3D) and ICE

Patient and procedural volume

Even recognized high-volume experts perform no more than 200–300 cases per year

 Not all centers will have expertise in all procedures

Implications for training

Wide spectrum of structural heart disease and subtle variability within each disease process

Each patient is different and the procedure nuanced

Multi-disciplinary

Team

Collaborative and mutually supportive interdepartmental relationships

Interventional Cardiology

Cardiothoracic Surgery

Nursing

Echocardiography and other Imaging Modalities

Anesthesiology

Columbia Valve Center

New York Presbyterian Hospital / Columbia University Medical Center

Columbia Valve Center

Team

Susan Schnell, NP

Phillip Green, MD

Jeffrey W. Moses, MD

Ajay Kirtane, MD

Martin B. Leon, MD

Benoit Daneault, MD

Mathew Williams, MD

Jean-Michel Paradis, MD

Susheel Kodali, MD

Philippe Genereux, MD

Craig R. Smith, MD

William A. Gray, MD

Rebecca Hahn, MD

Marian Hawkey, RN

Jeanie Sohn, CCRC