Current Clinical Applications of Three-Dimensional Echocardiography: When the Technique Makes the Difference

Abstract

Advances in ultrasound, computer, and electronics technology have permitted three-dimensional echocardiography (3DE) to become a clinically viable imaging modality, with significant impact on patient diagnosis, management, and outcome. Thanks to the inception of a fully sampled matrix transducer for transthoracic and transesophageal probes, 3DE now offers much faster and easier data acquisition, immediate display of anatomy, and the possibility of online quantitative analysis of cardiac chambers and heart valves. The clinical use of transthoracic 3DE has been primarily focused, albeit not exclusively, on the assessment of cardiac chamber volumes and function. Transesophageal 3DE has been applied mostly for assessing heart valve anatomy and function. The advantages of using 3DE to measure cardiac chamber volumes derive from the lack of geometric assumptions about their shape and the avoidance of the apical view foreshortening, which are the main shortcomings of volume calculations from two-dimensional echocardiographic views. Moreover, 3DE offers a unique realistic en face display of heart valves, congenital defects, and surrounding structures allowing a better appreciation of the dynamic functional anatomy of cardiac abnormalities in vivo. Offline quantitation of 3DE data sets has made significant contributions to our mechanistic understanding of normal and diseased heart valves, as well as of their alterations induced by surgical or interventional procedures. As reparative cardiac surgery and transcatheter procedures become more and more popular for treating structural heart disease, transesophageal 3DE has expanded its role as the premier technique for procedure planning, intra-procedural guidance, as well as for checking device function and potential complications after the procedure.

A Modified Echocardiographic Classification of Mitral Valve Regurgitation Mechanism: The Role of Three-dimensional Echocardiography

“…Pre-operative echocardiographic assessment of MV pathology has become of crucial importance with the transition from prosthetic mitral valve (MV) replacement to MV repair in the last decades. This has more recently been facilitated by development of newer echocardiographic techniques such as three-dimensional (3D) imaging1)2) and simultaneous biplane imaging 3)4)…”

Usefulness of three-dimensional echocardiography for the assessment of ventricular function in children: Comparison with cardiac magnetic resonance, with a focus on patients with arrhythmia

“…Three-dimensional echocardiography, with its rapid evolution during the last three decades, seems to be an accessible and inexpensive tool for the assessment of cardiac function in clinical practice because it combines the accuracy of magnetic resonance imaging with the already high and constantly expanding accessibility and cost effectiveness of two-dimensional ultrasound systems [18][19][20][21][22]. The image acquisition is faster than CMR and requires fewer consecutive regular heart beats to produce data of adequate quality.…”

Unexpected mechanism of mitral regurgitation in a patient post ALCAPA repair: Added value of three‐dimensional echocardiography

“…Two‐dimensional echocardiography (2DE) is recommended as a first‐line imaging modality for assessment of patients with mitral regurgitation (MR) and is often sufficient for diagnosis 1 . However, being a single‐plane technique, 2DE may provide less accurate evaluation of complex mitral valve (MV) pathology, such as flail, perforation, or cleft, and three‐dimensional echocardiography (3DE) is believed to overcome this limitation 2 . We present a clinical case illustrating the added value of 3DE in assessment of the MV morphology and identification of an unexpected mechanism of MR which was not previously diagnosed using conventional echocardiography.…”