Incremental Value of Live/Real Time Three-Dimensional over Two-Dimensional Transesophageal Echocardiography in the Evaluation of Right Coronary Artery Fistula

Abstract

We report an adult with a right coronary artery to right atrial fistula in whom live/real time three-dimensional transesophageal echocardiography with its ability to trace the entire course and obtain en face views of the fistula connections, was able to provide significant incremental information over two-dimensional transesophageal echocardiography.

Renaissance of Cardiac Imaging to Assist Percutaneous Interventions in Congenital Heart Diseases:The Role of Three-Dimensional Echocardiography and Multimodality Imaging

“…Echocardiographic imaging of fistulae can be challenging; 2D TTE and 2D TEE can give information about origin and distal exit points of fistula, as well as volume overload and severity of shunt ( 38 ), but they may have limitations in tracing its course and precisely define the site of drainage ( 39 ). Although limited, some experiences of percutaneous procedures under 3D TEE have been reported, highlighting how 3DE can add additional values in these complex scenarios ( 40 , 41 ).…”

Posicionamento sobre Indicações da Ecocardiografia em Cardiologia Fetal, Pediátrica e Cardiopatias Congênitas do Adulto – 2020

“…Existem outras aplicações na sala de hemodinâmica no qual o ecocardiograma 3D pode guiar os procedimentos: fechamento das fenestrações na cirurgia de Fontan, fistulas coronárias, rupturas do seio de Valsalva, regurgitação paravalvar, perfuração de septo e localização dos eletrodos no processo de ressincronização ventricular. [89][90][91][92][93][94] Um dos grandes desafios em cardiopatias congênitas é a avaliação dos volumes e função ventricular, por razões intrínsecas dos defeitos congênitos (posição cardíaca, anomalias de conexão, material não contrátil e diferenças de pré-carga ventricular, entre outras). Os softwares disponíveis foram desenvolvidos a partir da geometria ventricular esquerda de corações normais, o que muitas vezes invalida as informações obtidas pelo 3D.…”

Educational Series in Congenital Heart Disease: Three-dimensional echocardiography in congenital heart disease

“…9). Thus, the technique has found application in transcatheter closure of atrial septal defects and ventricular septal defects in particular as well as a range of other situations such as imaging of coronary artery fistulas, closure of baffle leaks and fenestrations (21, 22, 23). Although attempts are made to preserve native valves, particularly in younger patients, 3D echocardiography provides excellent imaging of prosthetic valves and their complications, including guidance of closure of paravalvar leaks.…”