From deep in the chest, somewhere just below the breastbone, a shortness of breath begins to develop and tighten like a vice. Known as dyspnea, this condition may be triggered by mild exertion such as climbing stairs, excitement, surprise, or stress. While dyspnea may be caused by a multitude of underlying diseases and conditions, the challenge is to identify its causes quickly and develop an accurate diagnosis – a prerequisite for optimal and timely therapy.
To accomplish this, Siemens has developed two paired elements: a unique new transesophageal echocardiography (TEE) probe that generates seamless, real-time images of anatomy and blood flow in 4D (three dimensions plus time), and an equally unique new algorithm known as “eSie Valves,” that uses the data generated by the probe to analyze and visualize the acquired image data and derive personalized models of the aortic and mitral valves. Based on machine learning, the algorithm incorporates key data from thousands of annotated images.
In the context of interventional valve therapies such as transcatheter aortic valve replacement (TAVR) and clipping of the mitral valve’s leaflets, this combination of technologies is being focused like a spotlight on key causes of death and quality-of-life impairment. The two most important valvular diseases addressed by these technologies are aortic valve stenosis (narrowing of the aortic valve which is located between the left ventricle and the aorta) and mitral valve regurgitation (a backflow of blood from the left ventricle into the left atrium due to incomplete closure of the mitral valve’s leaflets.)
Valvular heart disease, which also includes diseases of the pulmonary valve and tricuspid valve, affects 2.5 percent of the global population. Each year in the United States and Europe roughly 200,000 open heart surgeries are performed in order to repair or replace diseased valves. According to the American Heart Association, in the U.S. valve surgeries are among the most expensive and riskiest cardiac procedures, with an average cost of $164,238 and an in-hospital death rate of 3.63 percent. Advanced imaging may help to improve the diagnostic assessment of diseased patients and thus help to optimize patient management by helping to identify those patients who really need a surgical/interventional therapy and will have a chance to benefit from it.