Live/Real Time Three‐Dimensional Transesophageal Echocardiography

Sudhakar, Selvin; Khairnar, Prakash; Nanda, Navin C.

doi:10.1111/j.1540-8175.2011.01525.x

Cited by 14 publications

(12 citation statements)

References 63 publications

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“…9,10 It is particularly well-suited for MV evaluation due to transducer location. Combined with 3D TEE, virtual computational MV repair allows evaluation and prediction of physiologic valvular function before and after leaflet resection and/or ring annuloplasty.…”

Section: Discussionmentioning

confidence: 99%

Three‐Dimensional Echocardiography‐Based Prediction of Posterior Leaflet Resection

et al. 2014

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Clinical long-term outcomes have shown that partial leaflet resection followed by ring annuloplasty is a reliable and reproducible surgical repair technique for treatment of mitral valve (MV) leaflet prolapse. We report a 61-year-old male for three-dimensional transesophageal echocardiography (3D TEE)-based virtual posterior leaflet resection and ring annuloplasty. Severe mitral regurgitation was found and computational evaluation demonstrated substantial leaflet malcoaptation and high stress concentration. Following virtual resection and ring annuloplasty, posterior leaflet prolapse markedly decreased, sufficient leaflet coaptation was restored, and high stress concentration disappeared. Virtual MV repair strategies using 3D TEE have the potential to help optimize MV repair.

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Section: Discussionmentioning

confidence: 99%

Three‐Dimensional Echocardiography‐Based Prediction of Posterior Leaflet Resection

et al. 2014

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“…However, spontaneous rupture of both anterior and posterior chordae is very rare. Two‐dimensional and real time three‐dimensional TEE have incremental value in delineation of mitral chordal rupture …”

Section: Case Presentationmentioning

confidence: 99%

Spontaneous Bileaflet Chordal Rupture Secondary to Myxomatous Degeneration of the Mitral Valve

et al. 2014

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Case Presentation:A 60-year-old man presented with 1 month history of progressive dyspnea. His blood pressure, pulse rate, and respiratory rate were 120/ 70 mmHg, 92 beats/min, and 17 breaths/min, respectively. Clinical examination revealed a 4/6 pansystolic murmur that was loudest at the apex. Electrocardiogram (Burdick 8500 ECG, Cardiac Science Corporation, Bothell, WA, USA) showed normal sinus rhythm and laboratory findings were normal. The chest radiography showed cardiomegaly. Two-dimensional transthoracic and transesophageal echocardiography (TEE) with the transducer array at 60 degrees were performed and confirmed the presence of bileaflet chordal rupture, corresponding A2 and P2 scallops (Fig. 1A, movie clip S1) and severe posteriorly eccentric mitral regurgitation was detected by color Doppler imaging (movie clip S2). Real time three-dimensional TEE clearly delineated flail A2 and P2 scallops secondary to rupture of primary chordae (Fig. 1B, movie clip S3). The patient underwent mitral valve surgery. Myxomatous degeneration and ruptured chordae of both anterior and posterior mitral leaflets were seen macroscopically during surgery. As mitral valve repair was unsatisfactory, mitral valve replacement with a mechanical prostheses was performed. Primary myxomatous degeneration was confirmed histopathologically as degeneration of collagen of the pars fibrosa and deposition of acid mucopolysaccharides in the pars spongiosa of the valve in the absence of severe calcification or fibrosis, with no evidence of rheumatic valvular disease. Figure 1. Two-dimensional transesophageal echocardiography (TEE) showed the presence of bileaflet chordal rupture, corresponding A2 and P2 scallops A. and real time three-dimensional TEE delineated flail A2 and P2 scallops secondary to rupture of primary chordae B. Ao = aorta; LAA = left atrial appendage; LA = left atrium; LV = left ventricle; A2 and P2 are the corresponding scallops of anterior and posterior mitral leaflet, respectively, Arrows show the ruptured chordate of flailed leaflets.

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“…This case illustrates a third significant hazard associated with heavy valve and sinus calcification, namely threatened aortic perforation at the time of valve implantation, and the advantage of TEE in its detection. 3,4 Some adjustment in deployment technique was therefore possiblein mechanical terms, slower balloon inflation might permit adjacent tissues to absorb some of the pressure and so reduce energy transfer to this solid nondistensible mass (resulting in less translational movement of this mass). There is currently no published clinical data to confirm improved outcomes using this modified approach.…”

mentioning

confidence: 99%

The Pyramid of Danger: The Value of TEE in Detecting Risk of Aortic Perforation during TAVI

2013

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An 87-year-old man undergoing transcatheter aortic valve implantation (TAVI) for severe aortic stenosis was noted to have bulky calcification of the noncoronary aortic cusp, extending into the corresponding sinus, on transesophageal echocardiography (TEE). During balloon valvuloplasty, TEE demonstrated displacement of this calcium into the aortic wall, producing a distinctive pyramidal indentation and indicating threatened focal aortic perforation. Importantly, this hazard was not evident on corresponding x-ray cine-angiography and emphasizes the value of TEE in guiding TAVI procedures. This information allowed alteration in deployment technique for the TAVI valve and forewarned the team to increased risk of a major hazard at this stage.

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Live/Real Time Three‐Dimensional Transesophageal Echocardiography

Cited by 14 publications

References 63 publications

Three‐Dimensional Echocardiography‐Based Prediction of Posterior Leaflet Resection

Three‐Dimensional Echocardiography‐Based Prediction of Posterior Leaflet Resection

Spontaneous Bileaflet Chordal Rupture Secondary to Myxomatous Degeneration of the Mitral Valve

The Pyramid of Danger: The Value of TEE in Detecting Risk of Aortic Perforation during TAVI

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