Abstract Over the last decade, transcatheter structural heart interventions (TSHIs) have revolutionized the management of patients with structural heart disease (SHD), particularly those deemed high-risk or inoperable for conventional surgery. This rapid evolution has been propelled by innovations in both device technology and cardiovascular imaging, with echocardiography emerging as a cornerstone for procedural planning, real-time guidance and post-procedural assessment. This review outlines the expanding role of echocardiography across the spectrum of TSHIs, highlighting the importance of multimodality imaging, including three-dimensional transoesophageal echocardiography (3D TEE), intracardiac echocardiography (ICE) and fusion imaging techniques, for comprehensive structural evaluation and intraprocedural navigation. As the field continues to evolve, the demand for imaging specialists with procedural expertise is growing. Challenges remain in optimizing workflow, minimizing radiation exposure and enhancing image-guided precision. This review aims to outline the development of interventional imaging and promote best practices for procedural success and patient safety.
N. Ktenopoulos, K. Vlasopoulou, P. Vlachakis et al.· European heart journal. Imag...· 0 citations
Large language models (LLMs) have rapidly emerged as a transformative class of artificial intelligence systems capable of understanding and generating human-like text from vast corpora of clinical and scientific literature. While their use in general cardiology has been extensively reviewed, their specific role in interventional cardiology and within the catheterization laboratory (cath lab) environment remains less well characterized. This narrative review synthesizes the current evidence on LLM applications across the interventional cardiology workflow, including coronary revascularization decision-making, multidisciplinary Heart Team support, structural heart intervention planning, periprocedural communication, and acute cath lab decision support. Recent studies suggest that contemporary LLMs such as ChatGPT-4 (OpenAI), Claude (Anthropic), and Gemini (Alphabet, Inc.) can achieve clinically meaningful concordance with expert Heart Team recommendations for percutaneous coronary intervention vs coronary artery bypass grafting, and that their outputs may approach or even match those of early-career interventional cardiologists in simulated emergency scenarios. However, important limitations persist, including variable accuracy across prompt formats, susceptibility to hallucinations, lack of multimodal integration with angiographic and intravascular imaging, opacity of training sources, and unresolved medicolegal issues. The authors discuss the current evidence base, highlight promising avenues such as multimodal LLMs and retrieval-augmented generation tools that leverage current guidelines, and outline regulatory and ethical considerations that must accompany clinical adoption. LLMs are unlikely to replace interventional cardiologists in the foreseeable future, but they may meaningfully support decision-making, education, and patient communication in a domain where speed, complexity, and risk converge.
Ioannis Skalidis, Lisa Simioni, G. Beretta et al.· The Journal of invasive card...· 0 citations
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