3D Transesophageal Echocardiography: Systolic Anterior Motion with Hypertrophic Obstructive Cardiomyopathy

Willert, Jessica L.; D’Ambra, Michael N.

doi:10.1213/01.ane.0000204356.88460.80

Cited by 5 publications

(7 citation statements)

References 1 publication

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The measurement of mitral annular diameter, leaflet lengths, excessive length of PML, and the contribution of abnormal bands can be made out by 3D TEE. [53,54] The en-face view of the mitral valve in 3D aligned to the "surgeon's view" is helpful in identifying the prolapsed mitral scallop and demonstrating the complex anatomy of the mitral valve apparatus. [53] Post repair 3D TEE is helpful in assessing the adequacy of mitral valve repair and relief of LVOTO.…”

Section: Assessment Of Mitral Valvementioning

confidence: 99%

Hypertrophic cardiomyopathy part II - Anesthetic and surgical considerations

Varma¹,

Raman²,

Neema³

2014

Ann Card Anaesth

View full text Add to dashboard Cite

Hypertrophic cardiomyopathy (HCM) poses many unique challenges regarding the conduct of anesthesia and surgery. Adequate preload, control of sympathetic stimulation, heart rate, and increased afterload are required to decrease the left ventricular outflow tract obstruction. Comprehensive intraoperative transesophageal echocardiography (TEE) examination confirms the diagnosis, elucidates the pathophysiology, and identifies the various anomalies of mitral valve apparatus and allows assessment of the adequacy of surgery. In this review, we focus on the preoperative assessment, conduct of anesthesia and comprehensive TEE examination of patients presenting for surgery with HCM. The various surgical options are extended myectomy and resection, plication and release.

show abstract

Section: Assessment Of Mitral Valvementioning

confidence: 99%

Hypertrophic cardiomyopathy part II - Anesthetic and surgical considerations

Varma¹,

Raman²,

Neema³

2014

Ann Card Anaesth

View full text Add to dashboard Cite

show abstract

“…4 As shown by Willert et al, 3D-TEE might be especially helpful when patients present with a combination of both obstruction of the LVOT as well as intrinsic MV pathology. 5 In addition to information provided by Willert et al, our case emphasizes the novelty of real-time assessment of the MV and the LVOT and introduces additional features obtained by using available built-in software. Careful cropping of the 3D image of the LVOT at the point of maximal AMLseptal contact revealed a diastolic LVOT area of 6.25 cm 2 which significantly decreased to 4.57 cm 2 during systole ( Figs.…”

mentioning

confidence: 90%

Mitral Valve Prolapse and Systolic Anterior Motion Illustrated by Real Time Three-Dimensional Transesophageal Echocardiography

Jungwirth¹,

Adams²,

Mathew³

et al. 2008

Anesthesia &Amp; Analgesia

View full text Add to dashboard Cite

A56-yr-old man presented with increasing dyspnea with mild to moderate exercise. Transthoracic echocardiography demonstrated hypertrophic obstructive cardiomyopathy (HOCM), systolic anterior motion (SAM) of the anterior mitral valve (MV) leaflet, with a left ventricular outflow tract (LVOT) peak velocity of 4.2 m/s at rest (obtained from an apical window) and moderate to severe mitral regurgitation (MR). In agreement with current consensus guidelines, the patient was scheduled for left ventricular surgical septal myectomy. 1 The intraoperative two-dimensional transesophageal echocardiography (2D-TEE) before cardiopulmonary bypass confirmed the diagnosis of marked HOCM, SAM, and severe MR and identified a prolapse of the P2 scallop of the posterior mitral leaflet (PML) using standard midesophageal (ME) views (Video Clip 1; please see video clip available at www.anesthesia-analgesia.org). Severe MR was confirmed by both, a vena contracta of 7 mm and systolic reversal during Doppler interrogation of the pulmonary venous flow. Of note, the MR jet peaked in mid and late systole based on color flow Doppler. The MR jet originated anteriorly and was then directed centrally and slightly posteriorly, suggesting a significant role of SAM rather than PML prolapse alone in the etiology of MR (Video Clip 1). 2 The diastolic interventricular septal thickness measured 26 mm in the ME long axis view. M-mode assessment of the aortic valve in the ME aortic valve long axis view confirmed dynamic outflow tract obstruction, as leaflets opened initially, but closed in mid systole. Therefore, the patient underwent left ventricular septal myectomy aiming to alleviate LVOT obstruction and SAM and ultimately to improve the degree of MR. 2 However, 2D-TEE assessment after myectomy demonstrated unaltered MR and persistent SAM of the MV, prompting the surgeon to replace the MV with a low profile mitral prosthesis (29 mm mechanical St. Jude prosthesis). Immediate MV replacement, rather than an attempt to repair the MV, was selected to avoid the possibility of a third cardiopulmonary bypass run in case of an insufficient repair. Postoperative 2D-TEE and Doppler assessment showed the typical echocardiographic signature of a bileaflet tilting disk valve with no residual regurgitation and no residual outflow tract gradient, and the patient had an unremarkable recovery.This case of complex MV disease in the context of SAM and HOCM highlights the potential difficulties in identifying the etiology of MR. Specifically, it demonstrates the diagnostic dilemma to discern the This article has supplementary material on the Web site:www.anesthesia-analgesia.org.

show abstract

“…Several 3D echocardiographic techniques have been developed and applied to LV volume and mass [55][56][57][58][59][60][61] determination during the last decade. Assuming a circular area, the radius (b) is computed and mean wall thickness (t) derived from the short-axis epicardial and cavity areas.…”

Section: Three-dimensional Echocardiographymentioning

confidence: 99%

“…Piecewise smooth subdivision surfaces [57][58][59] were used in the Pixar movies 'Toy Story II' and 'Monsters Inc'. Piecewise smooth subdivision surfaces [57][58][59] were used in the Pixar movies 'Toy Story II' and 'Monsters Inc'.…”

Section: Surface Reconstructionmentioning

confidence: 99%

See 1 more Smart Citation

3D Echocardiography

2007

View full text Add to dashboard Cite

3D Transesophageal Echocardiography: Systolic Anterior Motion with Hypertrophic Obstructive Cardiomyopathy

Cited by 5 publications

References 1 publication

Hypertrophic cardiomyopathy part II - Anesthetic and surgical considerations

Hypertrophic cardiomyopathy part II - Anesthetic and surgical considerations

Mitral Valve Prolapse and Systolic Anterior Motion Illustrated by Real Time Three-Dimensional Transesophageal Echocardiography

3D Echocardiography

Contact Info

Product

Resources

About