Additional value of three-dimensional transesophageal echocardiography for patients with mitral valve stenosis undergoing balloon valvuloplasty

Langerveld, Jorina; Valočík, Gabriel; Plokker, H.W. Thijs; Ernst, Sjef M.P.G.; Mannaerts, Herman F.J.; Kelder, Johannes C.; Kamp, Otto; Jaarsma, Wybren

doi:10.1067/s0894-7317(03)00402-4

Cited by 42 publications

(24 citation statements)

References 34 publications

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“…The 3D shape of the mitral valve orifice is complex and preliminary data suggest that 3DE could visualize commissural splitting more accurately than 2DE. [8][9][10] In these series, a transoesophageal probe interfaced with a workstation was used. Clinical use of RT3DE (transthoracic imaging) for the assessment of the degree of commissural splitting has never been evaluated.…”

Section: Introductionmentioning

confidence: 99%

Three-dimensional evaluation of the mitral valve area and commissural opening before and after percutaneous mitral commissurotomy in patients with mitral stenosis

Messika–Zeitoun

Brochet

Holmin

et al. 2006

European Heart Journal

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Aims Management of patients with mitral stenosis (MS) relies on accurate evaluation of the mitral valve area (MVA). Planimetry (MVA 2D ) is considered as the reference method but must be performed at the tips of the leaflets with the correct plane orientation and therefore requires experienced operators. Realtime three-dimensional echocardiography (RT3DE) may overcome this limitation but its usefulness for experienced when compared with less experienced operators has not been evaluated. In addition, superiority of RT3DE for the evaluation of commissural splitting after percutaneous mitral commissurotomy (PMC) is unknown. Methods and results 60 patients were prospectively evaluated by 2D and RT3DE before and after PMC by experienced operators. Before PMC, MVA 3D was slightly higher than MVA 2D (1.15 + 0.25 vs. 1.06 + 0.22 cm 2 , P ¼ 0.0001) but correlation between methods was excellent (r ¼ 0.73, P , 0.0001), mean difference was small (0.09 + 0.18 cm 2 ) and clinically meaningless (three patients misclassified, two of whom had borderline MS severity). After PMC, MVA 3D did not differ from and correlated well with MVA 2D (1.87 + 0.37 vs. 1.85 + 0.32 cm 2 , P ¼ 0.36; r ¼ 0.76, P , 0.0001; mean difference 0.03 + 0.24 cm 2 ). Twenty-five additional patients were also evaluated both by an experienced and a less experienced operators. Bland-Altman analysis showed the better agreement between MVA 3D measured by the less experienced operator and MVA 2D measured by the experienced operator than between MVA 2D measured by the less experienced and the experienced operators (mean difference 0.03 + 0.34 vs. 20.13 + 0.46 cm 2 , P ¼ 0.03). When compared with RT3DE, 2DE underestimated the degree of commissural opening in 33% of patients and agreement between methods was weak (k ¼ 0.41). Conclusion RT3DE provides accurate MVA measurements similar to 2D planimetry performed by experienced operators. Thus, it does not provide a real advantage for experienced operators, whereas it seems particularly helpful for less experienced operators. In addition, RT3DE improves the description of valvular anatomy.

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Section: Introductionmentioning

confidence: 99%

Three-dimensional evaluation of the mitral valve area and commissural opening before and after percutaneous mitral commissurotomy in patients with mitral stenosis

Messika–Zeitoun

Brochet

Holmin

et al. 2006

European Heart Journal

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“…3D TEE had additional value over 2-dimensional echocardiography in this group of patients, for selection of patients pre-PTMV, and for analysing pathology of the mitral valve afterward. 9 Mitral regurgitation is common in male patients. 10 It has been reported that mitral valve regurgitation and aortic regurgitation are associated with lower body mass index, an index of body adiposity.…”

Section: Discussionmentioning

confidence: 99%

Sequelae Of Chronic Rheumatic Heart Disease Among Patients At Two Teaching Hospitals In Sindh, Pakistan

2006

J Liaquat Uni Med Health Sci

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OBJECTIVE: To evaluate different sequelae in adult patients of chronic rheumatic heart disease. DESIGN: A descriptive study. SETTING: This study was conducted at Liaquat University Hospital and Isra University Hospital, Hyderabad-Sindh from January 2003 to December 2004. METHODS: Patients of chronic rheumatic heart disease who presented at Liaquat University Hospital and Isra University Hospital were enrolled in the study. Demographic details of patients such as age, sex, socioeconomic status as well as their symptoms such as dysponea, palpitation and chest pain were noted on a proforma. Number of rheumatic fever attacks in the past were also noted. Patients were examined carefully for cardiac valvular lesions and for signs of acute rheumatic fever. Patients underwent different investigations such as blood complete picture, ESR, ASO titre, ECG, X-ray chest, echocardiography and Doppler. All patients had their calcium levels and collagen profile checked to exclude non rheumatic causes of valvular heart disease. RESULTS: One hundred adult patients of chronic rheumatic heart disease were studied for various valvular sequelae. Out of 100 patients studied, 49 (49%) patients were males and 51 (51%) were females. Seventy-three (73%) patients were below 30 years of age (Group A) and 27 (27%) patients were above 30 years of age (Group B). Patients age ranged between 12 and 60 years. Forty-eight (48%) patients had predominant mitral stenosis. Forty-two (42%) patients had predominant mitral regurgitation. Nine (9%) patients had aortic regurgitation and one (1%) had aortic stenosis along with mitral valve disease. CONCLUSION: From this study, it is concluded that mitral valve stenosis is frequently observed than mitral regurgitation and aortic valve is least affected, therefore, in every case of chronic rheumatic fever mitral valve should be thoroughly examined.

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“…8,9 In addition, improved assessment of anatomy and function of valves was achieved through better detail (figure 1), as well as the first time use of 3D colour flow jets. [10][11][12][13] With further advancements in technology, a transition from stepwise to continuous rotational scanning was achieved, offering the possibility of acquiring a complete 3D dataset within a single breath-hold of ten seconds. However, equal to freehand imaging there was still the necessity to interpolate between essentially multiple 2D images, making the technique sensitive to motion artefacts by involuntary movement of heart and lungs.…”

Section: Three-dimensional Echocardiographic Techniquesmentioning

confidence: 99%

Clinical application of three-dimensional echocardiography: past, present and future

Kleijn

Kamp²

2009

NHJL

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Significant advances in three-dimensional echocardiography have made this modality a powerful diagnostic tool in the cardiology clinic. It can provide accurate and reliable measurements of chamber size and function, including the quantification of left ventricular mechanical dyssynchrony to guide patient selection for cardiac resynchron-isation therapy. Furthermore, three-dimensional echocardiography offers novel views and comprehensive anatomic definition of valvular and congenital abnormalities, improving diagnosis and preoperative planning. In addition, it is extremely useful in monitoring the effectiveness of surgical or percutaneous transcatheter interventions. As its efficacy for more and more clinical applications is demonstrated, it is clear that three-dimensional echocardiography has become part of the routine clinical diagnostic armamentarium. In this article, we describe the development of three-dimensional echocardiography over the last decades, review the scientific evidence for its current clinical use and discuss potential future applications. (Neth Heart J 2009;17:18-24.).

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Additional value of three-dimensional transesophageal echocardiography for patients with mitral valve stenosis undergoing balloon valvuloplasty

Cited by 42 publications

References 34 publications

Three-dimensional evaluation of the mitral valve area and commissural opening before and after percutaneous mitral commissurotomy in patients with mitral stenosis

Three-dimensional evaluation of the mitral valve area and commissural opening before and after percutaneous mitral commissurotomy in patients with mitral stenosis

Sequelae Of Chronic Rheumatic Heart Disease Among Patients At Two Teaching Hospitals In Sindh, Pakistan

Clinical application of three-dimensional echocardiography: past, present and future

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