Catheter-based Mitral Valve Repair with the MITRACLIP
Transcatheter Aortic Valve Implantation (TAVI)
Catheter-based Renal Artery Denervation for Resistant Hypertension
The Watchman Device: A Novel Therapy for Prevention of Stroke in Atrial Fibrillation
Absorb Bioresorbable Vascular Scaffold
Dedicated Bifurcation drug-eluting Stent: Axxess Stent
Endovascular repair of aortic conditions: EVAR and TEVAR
Organ Transplantation and Mechanical Heart
Minimally Invasive Mitral Valve Repair and Replacement
Minimally Invasive Repair of Chest Wall Deformities
Cardiac Magnetic Resonance Imaging CMR
Real Time Live 3D TEE-guided Procedures and Surgeries
Sutureless Aortic Valve Replacement
PARACHUTE Left Ventricular Partitioning Device
The 2 Dimensional Transesophageal Echocardiography (2D TEE) has been available in the IJN operating room since 1990s and has revolutionised the technique of cardiac anaesthesia and surgery especially in the field of valve repair and the assessment of left ventricular function. Despite its limitation, intra operative 2D TEE has now become an integral part of cardiac surgery all over the world. As the result, a successful mitral valve repair surgery procedure becomes a distinct domain, and is expected of, from prominent sub specialty centres such as IJN.
In the last 4 years, we have seen another major advancement in ultrasound technology by the introduction of intra operative real time 3 Dimensional Transesophageal Echocardiography (RT3D TEE). Selected centres with the capability of this new frontier that provide more information and objective assessment of the heart, have shown a more remarkable advancement and achievement than before. The same scenario was seen in IJN.
The 3D TEE zoom mode provided an accurate assessment of the pathology of the mitral valve with regards to its physiologic classification and location of the lesion especially if it is a regurgitant lesion. It takes out the guessing game, allowing more accurate repair thus improving outcome.
Other areas where the RT3DTEE is very useful are for the repair of Ebstein’s anomaly, percutaneous placement of the left atrial appendage occluder, percutaneous placement of the ventricular septal defect occlude, trans apical placement of occlude for prosthetic mitral para valvular leaks, and percutaneous mitral clip procedure.