Direct measurement of left ventricular outflow tract by transthoracic real-time 3D-echocardiography increases accuracy in assessment of aortic valve stenosis

Khaw, Alexander V.; Bardeleben, Ralph Stephan von; Strasser, Christina; Mohr-Kahaly, Susanne; Blankenberg, Stefan; Espinola‐Klein, Christine; Münzel, Thomas; Schnabel, Renate B.

doi:10.1016/j.ijcard.2008.04.070

Cited by 60 publications

(38 citation statements)

References 35 publications

(29 reference statements)

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“…Previous studies using this method 25,26 revealed the elliptical morphology of the LVOT and an underestimation of the calculation of AVA and SVi compared with the LVOT measured by 2D TTE. Tamborini et al 27 showed that 3D TTE is a reliable and valid imaging alternative to MDCT in preoperative transcatheter aortic valve implantation evaluation.…”

Section: D Transesophageal Echocardiographic Methodologymentioning

confidence: 92%

Three-Dimensional Morphology of the Left Ventricular Outflow Tract: Impact on Grading Aortic Stenosis Severity

Caballero

Saura

Oliva-Sandoval

et al. 2017

Journal of the American Society of Echocardiography

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Section: D Transesophageal Echocardiographic Methodologymentioning

confidence: 92%

Three-Dimensional Morphology of the Left Ventricular Outflow Tract: Impact on Grading Aortic Stenosis Severity

Caballero

Saura

Oliva-Sandoval

et al. 2017

Journal of the American Society of Echocardiography

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“…1), providing incremental clinical usefulness compared with 2D TTE. Besides accurately assessing left ventricle (LV) volumes in valvular heart disease, 3D TTE has improved the assessment of valvular anatomic features and regurgitation as well as left ventricular outflow tract (LVOT) dimensions (2)(3)(4). In this review, we discuss the role of 3DE in evaluating valvular anatomic features, volumetric valve quantification, pre-surgical planning, intraprocedural guidance, and post-procedural assessment of valvular heart disease.…”

confidence: 99%

“…However, analysis of 3DE images has demonstrated that the LVOT cross-section is not always circular, but often is elliptical. By uniformly assuming a circular shape, AVA may be underestimated (4). It has been shown that accuracy of the AVA calculated by the continuity equation is improved by substituting planimetered LVOT area measured from 3DE (4).…”

Section: Aortic Valvementioning

confidence: 99%

Valvular Heart Disease

Lang

Tsang

Weinert

et al. 2011

Journal of the American College of Cardiology

109

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Significant advances in 3-dimensional echocardiography (3DE) technology have ushered its use into clinical practice. The recent advent of real-time 3DE using matrix array transthoracic and transesophageal transducers has resulted in improved image spatial resolution, and therefore, enhanced visualization of the pathomorphological features of the cardiac valves compared with previously used sparse array transducers. It has enabled an unparalleled real-time visualization of valves and subvalvular anatomic features from a single volume acquisition without the need for offline reconstruction. On-cart or offline post-processing using commercially available and custom 3-dimensional analysis software allows the quantification of multiple parameters, such as orifice area, prolapse height and volume in mitral valve disease, area of the left ventricular outflow tract, and tricuspid annular geometry. In this review, we discuss the incremental role of 3DE in evaluating valvular anatomic features, volumetric quantification, pre-surgical planning, intraprocedural guidance, and post-procedural assessment of valvular heart disease.

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“…More recent articles have suggested that direct measurement of the LVOT by transthoracic real-time 3D-echocardiography may increase the accuracy of this measurement. 27,28 In patients with a suboptimal window, transesophageal echocardiogram is a reasonable alternative. 29 There are also studies showing good accuracy in measuring the AVA with computed tomography and magnetic resonance.…”

Section: Outflow Tract Measurements Errorsmentioning

confidence: 99%

Clinical Challenges in Accurate Assessment of Severe Aortic Stenosis With a Special Focus on Low-Gradient Aortic Stenosis and Normal Ejection Fraction

Barboza

Krishnan²,

Ananthasubramaniam³

2011

Cardiology in Review

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Aortic stenosis (AS) is one of the most common valvular disorders affecting the aging US population. Although guidelines published by leading cardiac societies outline diagnostic and management strategies for this condition, in daily practice clinicians face dilemmas when trying to confirm the diagnosis of severe AS because of discrepancies in quantitative parameters obtained by echocardiography and cardiac catheterization. More recently, a low-gradient variant of severe AS has been increasingly recognized in the setting of normal ejection fraction. This review focuses on the current clinical challenges of AS diagnosis with a special focus on paradoxical low-flow low-gradient AS in the setting of preserved ejection fraction. We evaluate all aspects of AS quantitation in reference to paradoxical low flow aortic stenosis and discuss newer parameters which may help the clinician reconcile some of the discrepancies of this less understood condition.

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Direct measurement of left ventricular outflow tract by transthoracic real-time 3D-echocardiography increases accuracy in assessment of aortic valve stenosis

Cited by 60 publications

References 35 publications

Three-Dimensional Morphology of the Left Ventricular Outflow Tract: Impact on Grading Aortic Stenosis Severity

Three-Dimensional Morphology of the Left Ventricular Outflow Tract: Impact on Grading Aortic Stenosis Severity

Valvular Heart Disease

Clinical Challenges in Accurate Assessment of Severe Aortic Stenosis With a Special Focus on Low-Gradient Aortic Stenosis and Normal Ejection Fraction

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