Progress in Ring Array Transducers for Real-Time 3D Ultrasound Guidance of Cardiac Interventional Devices

Abstract

As a treatment for aortic stenosis, several companies have recently introduced prosthetic heart valves designed to be deployed through a catheter using an intravenous or transapical approach. This procedure can either take the place of open heart surgery with some of the devices or delay it with others. Real-time 3D ultrasound could enable continuous monitoring of these structures before, during and after deployment. We have developed a 2D ring array integrated with a 30 French catheter that is used for transapical prosthetic heart valve implantation. The transducer array was built using three 46 cm long flex circuits from MicroConnex (Snoqualmie, WA) which terminate in an interconnect that plugs directly into our system cable; thus, no cable soldering is required. This transducer consists of 210 elements at 0.157 mm interelement spacing and operates at 5 MHz. Average measured element bandwidth was 26% and average round-trip 50 ohm insertion loss was −58.1 dB after correcting for diffractive losses. The transducer was wrapped around the 1 cm diameter lumen of a heart-valve deployment catheter. Prosthetic heart valve images were obtained in water-tank studies.

Keywords

Aortic stenosis prosthetic heart valves real-time 3D ultrasound imaging ring array transducers

Get full access to this article

View all access options for this article.

References

Iung

Baron

Butchart

A prospective survey of patients with valvular heart disease in Europe: the Euro Heart Survey on valvular heart disease

Eur Heart J 24, 1231–124 (2003).

Bach

Siao

Girard

Evaluation of patients with severe symptomatic aortic stenosis who do not undergo aortic valve replacement

Circ Cardiovasc Qual Outcomes 2, 533–539 (2009).

Iung

Cachier

Baron

Decision-making in elderly patients with severe aortic stenosis: why are so many denied surgery?

Eur Heart J 26, 2714–2720 (2005).

Cribier

Eltchaninoff

Bash

Percutaneous transcatheter implantation of an aortic valve prosthesis for calcific aortic stenosis: first human case description

Circulation 106, 3006–3008 (2002).

Himbert

Descoutures

Al-Attar

Results of transfemoral or transapical aortic valve implantation following a uniform assessment in high-risk patients with aortic stenosis

J Am Coll Cardiol 54, 303–311 (2009).

Light

Lieu

Smith

New fabrication techniques for ring-array transducers for real-time 3D intravascular ultrasound

Ultrasonic Imaging 31, 247–256 (2009).

Jensen

Svendsen

Calculation of pressure fields from arbitrarily shaped, apodized, and excited ultrasound transducers

IEEE Trans Ultrason Ferro Freq Con 39, 262–267 (1992).

Born

Wolf

Principles of Optics, 7th ed.(Cambridge University Press, Cambridge, UK 1999).

Smith

Pavy

von Ramm

High speed ultrasound volumetric imaging system part I: transducer design and beam steering

IEEE Trans Ultrason Ferroelec Freq Contr 38, 100–108 (1991).

10.

von Ramm

Smith

Pavy

High speed ultrasound volumetric imaging system part II: Parallel processing and display

IEEE Trans Ultrason Ferroelec Freq Contr 38, 109–115 (1991).

11.

Pua

Idriss

Wolf

Smith

Real-time 3D transesophageal echocardiography

Ultrasonic Imaging 27, 217–232 (2004).

12.

Light

Idriss

Sullivan

Wolf

Smith

Real-time 3D ultrasonic laparoscopy

Ultrasonic Imaging 27, 89–100 (2005).

13.

Lee

Smith

Miniaturized catheter 2D for real-time 3D intracardiac echocardiography

IEEE Trans Ultrason Ferroelec Freq Contr 51, 1334–1346 (2004.)

14.

Light

Smith

Two dimensional arrays for real time 3D intravascular ultrasound

Ultrasonic Imaging 26, 115–128 (2004).

15.

Light

Smith

Two-dimensional arrays for real-time 3D intra-luminal ultrasound imaging.

Ultrasonic Imaging 26, 266–267 (2004) (abstract).

16.

Light

Davidsen

Hrushka

Smith

Progress in two-dimensional arrays for real time volumetric imaging

Ultrasonic Imaging 20, 1–16 (1998).

17.

Wang

Stephens

O'Donnell

A forward-viewing ring-annular ultrasound array for intravascular imaging, in Proc IEEE Ultrason Symp, pp. 1573–1576 (2001).

18.

Yeh

Oralkan

Wygant

O'Donnell

Khuri-Yakub

3-D ultrasound imaging using a forward-looking CMUT ring array for intravascular/intracardiac applications

IEEE Trans Ultrason Ferroelec Freq Contr 53, 1202–1211 (2006).