Mobile Echocardiography and Echoscopy Patricia Rant, MCU-PH - PowerPoint PPT Presentation

Mobile Echocardiography and Echoscopy Patricia Réant, MCU-PH Cardiologie, Bordeaux Janvier 2013

Conflict of interest disclosure (4yrs) In link with the Research, Congres present Communication studies displacement communication Practical BMS No - - teaching 2012 JESFC 2012 Toshiba No - - and Printemps 2011 Servier No - - EuroEcho 2011 Sanofi No Biarritz dec 2012 - - Saint Jude No - Yes - Astra Zeneca No PUT nov 2012 - - FFC No - Yes -

1942 : Karl Dussik, the first doctor having used ultrasounds for medical diagnosis

Standard ‘Blue goose’ ultrasonic system 1970 1990 L’oie bleue…

First portative system 1999

Portative ultrasonic systems All the functionalities 2004 Vivid I

Vivid I Weiner et al J Am Soc Echocardiogr 2012;25:568-575

Pocket-sized ultrasound system 2009 : Vscan

Validation of imaging capabilities  Qualitative detection of the mean cardiac abnormalities  100 patients for cardiologic evaluation  Comparison to standard Versus echocardiography  Inclusion criteria : all patient addressed to the echocardiographic department  Exclusion criteria : none  2 observers : VSCAN & Echo Lafitte S et al Ultrasound Med Biol 2011;37:798-804

Concordance Lafitte S et al Ultrasound Med Biol 2011;37:798-804

Vscan 89 patients from a small isolated village of the Honduras… Choi BG et al J Am Soc Echocardiogr 2011;24:1325-30

Clinical application  VSCAN and abdominal aorta aneurism detection  Inclusion criteria : hospitalized patients (cardio or others)  Exclusion criteria : none  Sample : 200 patients  Comparison of the management with and without echoscopic evaluation Prevalence = 7.5% Dijos M et al Echocardiography 2012;29:285-290

Clinical application  Echoscopy to evaluate pericardial effusion  Detection of the pericardial effusion in hospitalized patients  Inclusion criteria : after coronary bypass graft or AF ablation  Exclusion criteria : absence of pre-op echocardiography in the echolab  Sample : 59 patients echoscopy (Vscan)  Comparison of the conventional management at the echolab vs « bedside » by echoscopy Reant P et al Arch CV Dis 2011;104:171-7

Reant P et al Arch CV Dis 2011;104:171-7

Other pocket ultrasound system : Acuson P10: LV dimensions and function evaluation Fukuda S et al Circ J 2009;73:1092-1096

EAE Guidelines 2011 Sicari et al Eur Asso Echocardiogr. Eur Heart J 2011;32:385-392

Sicari et al Eur Asso Echocardiogr. Eur Heart J 2011;32:385-392

Conclusions  Mobile echocardiography is useful in term of descrambling (consultations, SAMU, emergencies,..), validated in the detection of the mean cardiac abnormalities  Need of certification  EAE considers echoscopy as a prolongation of the physical examination (as the stethoscope) and does not position itself in term of repayment  Echoscopy does not replace complete echocardiography and should indicate its necessity