Accuracy of real-time 3D echocardiography in the evaluation of functional anatomy of mitral regurgitation

Agricola, Eustachio; Oppizzi, Michele; Pisani, Matteo; Maisano, Francesco; Margonato, Alberto

doi:10.1016/j.ijcard.2007.05.010

Cited by 50 publications

(31 citation statements)

References 20 publications

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“…Ahmed and colleagues have shown that there might be a difference between the surgical inspection and the echocardiographic finding, especially in nonpronounced prolapses. [12] Grewal et al [13] had 2 different echocardiographers performing the 2D and 3D views, and the results were analyzed at a later time. Because it was an offline analyses, the echocardiographers had assessed the stored loops and had not performed the TEE examination themselves, at that point of time.…”

Section: Discussionmentioning

confidence: 99%

Real-time three-dimensional echocardiographic assessment of mitral valve: Is it really superior to 2D transesophageal echocardiography?

et al. 2011

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Aim of our study was to investigate the feasibility of use and possible additional value of real-time 3D transesophageal echocardiography (RT-3D-TEE) compared to conventional 2D-TEE in patients undergoing elective mitral valve repair. After ethical committee approval, patients were included in this prospective study. After induction of anesthesia, a comprehensive 2D-TEE examination was performed, followed with RT-3D-TEE. The intraoperative surgical finding was used as the gold standard for segmental analysis. Only such segments which were surgically corrected either by resection or insertion of artificial chords were judged pathologic. A total of 50 patients were included in this study; usable data were available from 42 of these patients . Based on the Carpentier classification, the pathology found was type I in 2 (5%) patients, type II in 39 (93%) patients and type IIIb in 1 (2%) patient. We found that 3D imaging of complex mitral disease involving multiple segments, when compared to 2D-TEE did not show any statistically significant difference.RT-3D-TEE did not show any major advantage when compared to conventional 2D-TEE for assessing mitral valve pathology, although further study in a larger population is required to establish the validity of this study.

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Section: Discussionmentioning

confidence: 99%

Real-time three-dimensional echocardiographic assessment of mitral valve: Is it really superior to 2D transesophageal echocardiography?

et al. 2011

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“…The diagnostic accuracy of RT3DE evaluation of functional anatomy of mitral regurgitation also was demonstrated recently against surgical findings. 73 The more complex the mitral lesion is, the more valuable 3D echocardiography is compared with 2D TEE. 74 An important technological advancement in the last 3 years was the development of dedicated software to allow advanced 3D rendering of the valves and quantitative analysis of mitral apparatus geometry (Figure 12).…”

Section: Mor-avi Et Almentioning

confidence: 99%

Real-Time 3-Dimensional Echocardiography

2009

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O ne of the most significant developments of the last decade in ultrasound imaging of the heart was the evolution of 3-dimensional (3D) imaging from slow and labor-intense offline reconstruction to real-time volumetric imaging. This imaging modality provides valuable clinical information that empowers echocardiographers with new levels of confidence in the diagnosis of heart disease. We have previously described the technological milestones in the development of real-time 3D echocardiographic (RT3DE) imaging and its major advantages over conventional 2-dimensional echocardiography (2DE) and reviewed the published literature that supported the use of this new methodology in clinical practice. 1 Since 2006, the growing availability of RT3DE technology, its ease of use, and its multiple attractive features have sparked significant interest in the research community, resulting in a large number of publications, most of which have endorsed RT3DE imaging for clinical use by demonstrating its unique capabilities in different scenarios. In parallel, the clinical acceptance of this new tool has broadened significantly. The most recent clinically significant addition is matrix-array transesophageal echocardiography (TEE), which provides images of unprecedented quality that aid surgeons and interventional cardiologists in planning and guiding procedures and evaluating their outcomes.The purpose of the present article is to review the most recent RT3DE literature and provide readers with an update on the latest developments and the current status of this noninvasive imaging tool. Because different potential applications of RT3DE imaging have been explored to various extents, they are described here separately, and each is discussed with an emphasis on the scientifically established facts, along with the known stumbling blocks and difficulties. Quantification of LV Volumes and FunctionA firmly established advantage of 3D imaging over crosssectional slices of the heart is the improvement in the accuracy of the evaluation of left ventricular (LV) volumes and ejection fraction (EF) by eliminating the need for geometric modeling, which is inaccurate in the presence of aneurysms, asymmetrical ventricles, or wall motion abnormalities, and the errors caused by foreshortened views even in symmetrical ventricles. The value of RT3DE imaging in this context has been demonstrated by multiple studies that compared RT3DE volume measurements with widely accepted reference techniques, including radionuclide ventriculography and cardiac magnetic resonance (CMR). [2][3][4][5][6] These studies and others have demonstrated higher levels of agreement between the RT3DE approach and the respective reference technique compared with conventional 2DE methodology. Additionally, RT3DE measurements were found to be more reproducible than 2DE 4,5,7 and, in some studies, even as reproducible as CMR. 8 Interestingly, in a recent study in patients after myocardial infarction (MI), 9 RT3DE-derived LV volumes were more accurate and more reproducible than thos...

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“…12 Recent reports indicate that TEE accurately and consistently demonstrates mitral leaflet dysfunction. [13][14][15][16][17] However, the efficacy of echo-guided mitral repair has not been established. 18,19 We developed a succinct set of precisely defined images observed to be highly concordant with intraoperative findings.…”

Section: Clinical Perspective On P 141mentioning

confidence: 99%

Echo-Guided Mitral Repair

Drake

Zimmerman

Hepner

et al. 2014

Circ: Cardiovascular Imaging

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Background-Echocardiography is available in the most basic healthcare environments. Mitral repair is potentially curative and, when possible, recommended over replacement. The efficacy of echo-guided repair has not been established. Methods and Results-We developed a succinct set of precisely defined images observed to be highly concordant with intraoperative findings. These images guided intervention on 237 consecutive patients. None were lost to follow-up, and serial echocardiography was obtained on all repairs. This analysis includes 2037 echocardiograms.

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Accuracy of real-time 3D echocardiography in the evaluation of functional anatomy of mitral regurgitation

Cited by 50 publications

References 20 publications

Real-time three-dimensional echocardiographic assessment of mitral valve: Is it really superior to 2D transesophageal echocardiography?

Real-time three-dimensional echocardiographic assessment of mitral valve: Is it really superior to 2D transesophageal echocardiography?

Real-Time 3-Dimensional Echocardiography

Echo-Guided Mitral Repair

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