Localization and quantification of mitral valve prolapse using three-dimensional echocardiography

Delabays, Alain; Jeanrenaud, Xavier; Chassot, Pierre Guy; Segesser, Ludwig Karl von; Kappenberger, Lukas

doi:10.1016/j.euje.2004.03.007

Cited by 56 publications

(33 citation statements)

References 19 publications

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“…More recently, software advances have reduced the mean acquisition and reconstruction times increasing the clinical feasibility of the technique. However, despite significant clinical advantages of 3D-TOE over 2D-TOE particularly for the localization of MV prolapse [7,9,10,22,23], 3D-TOE based on the imaging reconstruction has not been universally accepted in routine clinical practice because of its cost and the need for offline processing. The miniaturization of previously developed transthoracic 3D matrix-array transducers has allowed their adaptation into the tips of otherwise conventional transoesophageal probes, resulting in fully sampled matrix-array transducers.…”

Section: Discussionmentioning

confidence: 97%

Real-time three-dimensional transoesophageal echocardiography: a new intraoperative feasible and useful technology in cardiac surgery

Gripari

Tamborini

Barbier

et al. 2010

Int J Cardiovasc Imaging

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A new generation of transoesophageal echocardiographic probes with a novel matrix array technique has been recently introduced, allowing three-dimensional (3D) presentation of cardiac structures in real-time. This new tool may potentially provide fast and complete 3D information about cardiac structures improving spatial orientation and overcoming limitations of offline 3D technologies. The aim of this study was to demonstrate the feasibility and usefulness of real-time 3D transoesophageal echocardiography (TOE) for the intraoperative evaluation of cardiac surgery procedures. One-hundred patients underwent transoesophageal echocardiographic examination during cardiac surgery as a part of their routine clinical practice. In the intraoperative pre- and post-cardiopulmonary bypass periods complete 2D and 3D transoesophageal examinations were performed. Feasibility and duration of examinations, and immediate additional anatomical value of 3D versus 2D-TOE were annotated intraoperatively. Image quality, additional clinical value of 3D- compared to standard 2D-TOE and the accuracy in the description of mitral valve pathology by a surgeon and an echocardiographer were evaluated off-line. No complications related to transoesophageal examination occurred and successful intubation was achieved in all 100 patients. Therefore, 200 examinations were performed and analysed considering the pre- and post-cardiopulmonary bypass periods. The mean number of acquisitions per patient was 16 +/- 14, including 3D real-time, zoom, full-volume and colour full volume modalities. The duration of the 3D examination was 16 +/- 10 min and the mean image quality score 2.8 +/- 0.7 (in a scale 1-4). In 36 out of 100 cases (36%) 3D-TOE provided additional anatomical information. The surgeon evaluated 3D images easier and more accurately than 2D images (88% vs. 76% in the evaluation of mitral valve scallop). Real-time 3D TOE may be used routinely for the intraoperative evaluation of cardiac surgery. Imaging with this new probe facilitates intraoperative evaluation of several surgical procedures with an additional clinical value in selected cases.

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Section: Discussionmentioning

confidence: 97%

Real-time three-dimensional transoesophageal echocardiography: a new intraoperative feasible and useful technology in cardiac surgery

Gripari

Tamborini

Barbier

et al. 2010

Int J Cardiovasc Imaging

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“…However, the severity and magnitude of prolapse has been difficult to accurately determine preoperatively using 2D TEE, especially in valves with multisegmental lesions. 20,21 This is probably the case because 3D TEE is less operator-dependent than 2D TEE that relies on fine adjustments of the TEE probe and mental integration of a limited number of 2D imaging planes to delineate MV pathology. Analysis in a subset of our patients demonstrated higher agreement between qualitative assessment of 3D images and surgical findings when compared with 2D images.…”

Section: Discussionmentioning

confidence: 99%

Characterization of Degenerative Mitral Valve Disease Using Morphologic Analysis of Real-Time Three-Dimensional Echocardiographic Images

Chandra

Salgo

Sugeng

et al. 2011

Circ: Cardiovascular Imaging

151

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Background-Presurgical planning of mitral valve (MV) repair in patients with Barlow disease (BD) and fibroelastic deficiency (FED) is challenging because of the inability to assess accurately the complexity of MV prolapse. We hypothesized that the etiology of degenerative MV disease (DMVD) could be objectively and accurately ascertained using parameters of MV geometry obtained by morphological analysis of real-time 3D echocardiographic (RT3DE) images. Methods and Results-Seventy-seven patients underwent transesophageal RT3DE study: 57 patients with DMVD studied intraoperatively (28 BD, 29 FED classified during surgery) and 20 patients with normal MV who were used as control subjects (NL). MVQ software (Philips) was used to measure parameters of annular dimensions and geometry and leaflet surface area, including billowing volume and height. The Student t test and multinomial logistic regression was performed to identify parameters best differentiating DMVD patients from normal as well as FED from BD. Morphological analysis in the DMVD group revealed a progressive increase in multiple parameters from NL to FED to BD, allowing for accurate diagnosis of these entities. The strongest predictors of the presence of DMVD included billowing height and volume. Three-dimensional billowing height with a cutoff value of 1.0 mm differentiated DMVD from NL without overlap, and billowing volume with a cutoff value 1.15 mL differentiated between FED and BD without overlap. Conclusions-Morphological analysis as a form of decision support in assessing MV billowing revealed significant quantifiable differences between NL, FED, and BD patients, allowing accurate classification of the etiology of MV prolapse and determination of the anticipated complexity of repair. (Circ Cardiovasc Imaging. 2011;4:24-32.)

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“…Three-dimensional (3D) TEE has been demonstrated to be superior to bi-dimensional (2D) imaging in the description of all different forms of mitral valve pathology, and particularly helpful in complex valve disease with the involvement of several scallops and of commissural segments with high negative predictive value [3][4][5][6]. Additionally, first studies with International Journal of Cardiology 127 (2008) 342 -349 www.elsevier.com/locate/ijcard transthoracic real-time 3D echocardiography (RT3DE) have been performed and demonstrated that RT3DE of mitral valve is feasible in a large majority of patients [7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Accuracy of real-time 3D echocardiography in the evaluation of functional anatomy of mitral regurgitation

Agricola

Oppizzi

Pisani

et al. 2008

International Journal of Cardiology

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Localization and quantification of mitral valve prolapse using three-dimensional echocardiography

Cited by 56 publications

References 19 publications

Real-time three-dimensional transoesophageal echocardiography: a new intraoperative feasible and useful technology in cardiac surgery

Real-time three-dimensional transoesophageal echocardiography: a new intraoperative feasible and useful technology in cardiac surgery

Characterization of Degenerative Mitral Valve Disease Using Morphologic Analysis of Real-Time Three-Dimensional Echocardiographic Images

Accuracy of real-time 3D echocardiography in the evaluation of functional anatomy of mitral regurgitation

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