Echo in the palm of your hand

Anthony DeMaria, MDChief of Cardiovascular Medicine University of California at San DiegoSan Diego, CA

Handheld machines

Echo in the palm of your hand

© 2000 SonoSite, Inc

Where are we now?

Echo in the palm of your hand

Echocardiography offers access to intercardiac anatomy and dynamics.

Heavy, large, expensive equipment limited usefulness.

The diminishing size and cost is expanding who and when can receive it.

Machine specs

Echo in the palm of your hand

SonoSite received FDA 510(k) premarket clearance for the SonoHeart in Dec 1999

5.4 lbs (2.4 kg)

$10,000-15,000

2D and Color Power Doppler scan

Primary applications

Echo in the palm of your hand

“I think that there is a value to think of these devices not as echocardiographs but as screening ultrasound devices.”

Anthony DeMaria, MDChief of Cardiovascular Medicine University of California at San DiegoSan Diego, CA

Evolution of use

Echo in the palm of your hand

Four steps of future use:

emergency imaging

screening

extended physical examination

fully portable echo

Expanding potential

Echo in the palm of your hand

“These devices enable us to potentially do ultrasound on more patients than we’ve done before, and enable us to perhaps expand the number of people who are using ultrasound.”

Anthony DeMaria, MDChief of Cardiovascular Medicine University of California at San DiegoSan Diego, CA

Echo in the palm of your hand

Stroke distance* at discharge

Post AMI mortality rate

1 month 5 years

> 100% of age-predicted normal 0% < 20%

< 65% of age-predicted normal 18% 43%

*the systolic velocity integral of blood flow in the aortic arch

UK researchers followed 378 patients for 5 years after AMI

Trent RJ, Rawles JM. Heart 1999;82:187-191

Stroke-distance and AMI survival

Clinical use

Echo in the palm of your hand

Echoes in the emergency room allows for an increase in diagnostic yield. This potential is furthered by handheld devices.

Can you teach people to perform a reasonable ultrasound examination and extract useful information?

There is significant improvement with a short educational process.

Screening

Echo in the palm of your hand

Has been used in pre-athletic screening.

A Heart for Sports Foundation(http://www.aheartforsports.org/)

Size of the device made it possible to screen large number of athletes in a short period of time.

Ubiquity

Echo in the palm of your hand

Technology will make ultrasound more available and easier to use.

Expertise and technique are incredibly important.

Ultrasound may never be as ubiquitous as ECG for emergency equipment.

Echo in the palm of your hand

© 2000 SonoSite, Inc