ESCR Webinar 05 – Level Advanced
Date: Wednesday, November 13, 2019, at 18:00 CET
Title: “Cardiac imaging before intervention in structural heart disease“
Moderator: Prof. Marco Francone, Rome/IT
"What do we need prior to treatment of intracardiac defects"
Dr. Aurelio Secinaro, Rome/IT
"What cardiac imaging can provide in / for Electrophysiology"
Dr. Antonio Esposito, Milan/IT
Lecture 1 - details
The number of adults with congenital heart disease is expected to increase over the next decade. Although acquired intracardiac defects are being increasingly recognized in adults, congenital heart disease remains the most common etiology. Advances in cardiac imaging, device technology, and transcatheter techniques, percutaneous closure is now feasible and safe for most intracardiac defects with limited need for surgical approach. There is an increasing role of CT and MR in clinical work-up of intracardiac defects, both techniques can support the identification of anatomical landmarks and MR is accurate in quantifying shunt (Qp:Qs). Device closure is considered the first-line therapy for a variety of congenital intracardiac defects, in particular ostium secundum atrial septal defects and muscular ventricular septal defects; it represents also an alternative therapeutic option for patients with acquired defects such as posttraumatic or postinfarction ventricular septal defects. In addition, detailed 3D anatomy derived from CT/MR images can be used for treatment planning, for virtual or physical simulation (on 3d printed models) and for patient-specific or disease-specific device prototyping and engineering.
• to recognize the most common intracardiac defects with CT/MR
• to understand their pathophysiology and perform accurate shunt quantification
• to identify most important cardiac defects landmarks in order to better guide intervention/surgery
• what are the major complications of intracardiac intervention/surgery
About the speaker
Dr Aurelio Secinaro is Radiology Consultant and Head of the Advanced Cardiovascular Imaging Unit at the Bambino Gesù Children’s Hospital and Research Institute in Rome. He’s skilled in performing cardiac MR and CT in children with congenital heart disease and cardiomyopathies. After his medical studies in Turin he completed his training at Great Ormond Street Hospital for Children, University College of London, where he obtained the maximum level of certification in Cardiovascular cross-sectional Imaging under the supervision of Prof. Andrew Taylor. He is involved in the Grown-Up Congenital Heart disease project in collaboration with the Policlinico Gemelli, Catholic University in Rome. He’s been part of several European Research Projects and he’s currently Project Manager for the Institutional 3D virtual modeling/printing program. Author and coauthor of several pubmed indexed publications, he is member of different national and international diagnostic imaging societies and regularly invited speaker/moderator at scientific meetings. In the past few years he joined the European Society of Pediatric Radiology (ESPR) Educational Committee as member responsible for reappraisal on Cardiothoracic Imaging.
Lecture 2 - details
Over the past decades, major advances have occurred in both electrophysiology and cardiac imaging. Electrophysiology have evolved toward the treatment of complex structural based arrhythmias, with a growing need of anatomical and structural planning and guide. At the same time, Cardiac MR and Cardiac CT have importantly increased their impact in the comprehension of the structural substrate of both atrial and ventricular arrhythmias, gaining a central role in the diagnostic management of arrhythmias. Over the last years, increasing evidences suggest the strong potential impact of the integration of Cardiac MR and Cardiac CT with electroanatomic maps in the guide of the ablation treatments of both atrial and ventricular arrhythmias. The imaging integration in the electrophysiological procedures is one of the most advanced and exciting fields of cardiac imaging research. The current possibilities and the future directions of cardiac imaging in this setting will be presented.
• Basic principles of ablation treatments of arrhythmias
• Main role of imaging before the ablation of atrial and ventricular arrhythmias
• Cardiac CT and Cardiac MR merging with electroanatomic maps: how and why
• Future directions for the development of Cardiac MR and Cardiac CT as tools for guiding arrhythmias ablation
About the speaker
Antonio Esposito is Associate Professor of Radiology at Vita-Salute San Raffaele University and Deputy-Director of the Experimental Imaging Center of San Raffaele Scientific Institute (SRSI).
He has long time experience in the field of body application of advanced imaging with MRI and CT, with a particular focus on cardiovascular applications. He developed an intensive clinical and preclinical research on these issues, with more than 120 manuscripts published in peer-reviewed journals.
He is the Responsible of the Functional Unit of Cardiovascular Imaging at the Department of Radiology of IRCCS San Raffaele Hospital.
He leads the Preclinical Imaging Facility of the same Research Hospital, a service and research facility equipped with CT, MRI, Optical, US and Photoacustic imaging technologies dedicated to the experimental study of small animal models of diseases.