Real Time Three‐Dimensional Echocardiography Evaluation of Intracardiac Masses

Zaragosa-Macias, Elisa; Chen, Michael A.; Gill, Edward A.

doi:10.1111/j.1540-8175.2011.01627.x

Cited by 61 publications

(46 citation statements)

References 47 publications

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“…Therefore, the study findings are of clinical relevance and add to previous studies in general populations and 5 isolated case reports of Libman-Sacks endocarditis on the complementary value of 3D-TEE to 2D-TTE or 2D-TEE for the detection, characterization, and differentiation of non-infective and infective vegetations, valve tumors, thrombus, and nodular calcifications (13–16,23–28,). Also, 3D-TEE may have additive complementary value to 2D-TEE in the diagnosis of embolic cerebrovascular disease in SLE.…”

Section: Discussionsupporting

confidence: 73%

“…All these factors may also explain the uncommon significant valve dysfunction (regurgitation or stenosis) and absence of valve perforations in patients with Libman-Sacks endocarditis in contrast to the frequent finding of moderate or severe valve regurgitation and valve perforations in patients with infective endocarditis. The described echocardiographic features should help to differentiate Libman-Sacks vegetations from the independently highly mobile, narrow base attachment, and elongated infective vegetations, Lambl’s excrescences, and papillary fibroelastomas (13–16,22–29). However, the presumed echocardiographic diagnosis of non-infective vegetations requires integration of clinical and laboratory data and in some cases of bacteriologic studies.…”

Section: Discussionmentioning

confidence: 99%

“…Libman-Sacks vegetations by either technique were defined as abnormal localized, protruding, and sessile echodensities of >3 mm in diameter with well-defined borders either as part of or adjacent to valve leaflets, annulus, subvalvular apparatus, or endocardial surfaces (1–8,12,13). The cutoff of >3 mm in diameter was adopted to prevent misinterpretation of Lambl’s excrescences as vegetations.…”

Section: Methodsmentioning

confidence: 99%

“…Multiplane two-dimensional (2-D) transesophageal echocardiography (TEE) has high diagnostic value for detection of Libman-Sacks endocarditis (5,6,8,12). Three-dimensional TEE (3D-TEE) has emerged as an important complementary technique to 2D-TEE for detection and characterization of infective vegetations and valve tumors (13–16). However, no previous study has been reported on the diagnostic value and clinical relevance of 3D-TEE in Libman-Sacks endocarditis.…”

Section: Introductionmentioning

confidence: 99%

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Libman-Sacks Endocarditis: Detection, Characterization, and Clinical Correlates by Three-Dimensional Transesophageal Echocardiography

Roldan

Tolstrup

Macias

et al. 2015

Journal of the American Society of Echocardiography

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Background Libman-Sacks endocarditis, characterized by Libman-Sacks vegetations, is common in patients with systemic lupus erythematosus (SLE), and is commonly complicated with embolic cerebrovascular disease. Thus, accurate detection of Libman-Sacks vegetations may lead to early therapy and prevention of their associated complications. Although two-dimensional transesophageal echocardiography (2D-TEE) has high diagnostic value for detection of Libman-Sacks vegetations, three-dimensional TEE (3D-TEE) may allow improved detection, characterization, and clinical correlations of Libman-Sacks vegetations. Methods 29 SLE patients (27 women, age 34±12 years) prospectively underwent 40 paired 3D-TEE and 2D-TEE studies and assessment of cerebrovascular disease manifested as acute clinical neurologic syndromes, neurocognitive dysfunction, or focal brain injury on MRI. Initial and repeat studies in patients were intermixed in a blinded manner with paired studies from healthy controls, de-identified, coded, and independently interpreted by experienced observers unaware of patients’ clinical and imaging data. Results 3D-TEE as compared to 2D-TEE studies were more often positive for mitral or aortic valve vegetations, detected more vegetations per study, and determined larger size of vegetations (all p≤0.03). Also, 3D-TEE detected more vegetations on the anterior mitral leaflet, anterolateral and posteromedial scallops, and ventricular side or both atrial and ventricular sides of the leaflets (all p<0.05). In addition, 3D-TEE detected more vegetations on the aortic valve left and non-coronary cusps, coronary cusps’ tip and margins, and aortic side or both aortic and ventricular sides of the cusps (all p≤0.01). Furthermore, 3D-TEE detected more often associated mitral or aortic valves’ commissural fusion (p=0.002). Finally, 3D-TEE detected more vegetations in patients with cerebrovascular disease (p=0.01). Conclusion 3D-TEE provides clinically relevant additive information that complements 2D-TEE for the detection, characterization, and association with cerebrovascular disease of Libman-Sacks endocarditis.

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Section: Discussionsupporting

confidence: 73%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Libman-Sacks Endocarditis: Detection, Characterization, and Clinical Correlates by Three-Dimensional Transesophageal Echocardiography

Roldan

Tolstrup

Macias

et al. 2015

Journal of the American Society of Echocardiography

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“…Realtime threedimensional TEE adds further information to the evaluation of thrombus by determining homogene ity, vascularity, calcification, necrosis and differentiates a thrombus from a tumor mass. 12 The pattern of respiratory variation in mitral valve and pulmonary vein flow veloci ties may reverse with positive pressure ventilation in CCP. 13 The TEE, thus, helps in structural as well as hemodynamic assessment in CCP.…”

Section: Discussionmentioning

confidence: 99%

Modification in Surgical Plan following Intraoperative Detection of Co-existent Right Atrial Thrombus by Transesophageal Echocardiography in Chronic Constrictive Pericarditis

Mahajan¹,

Ganesan²

2017

Journal of Perioperative Echocardiography

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Introduction Chronic constrictive pericarditis (CCP) is common in developing countries, tuberculosis being the most common cause. Dyspnea and congestive symptoms are the most common nonspecific presenting symptoms that require further evaluation for clinching the diagnosis. Coexistent right atrial (RA) thrombus and CCP are rare occurrences. Preoperative detection of RA thrombus is very important to avoid the risk of pulmonary thromboembolism during pericardiectomy or cannulation for establishing cardiopulmonary bypass (CPB). Perioperative echocardiography may play a crucial role in this setting. We report a case of CCP in which preoperative transesophageal echocardiography (TEE) detected RA thrombus that led to change in surgical plan and provided continuous monitoring during surgery. Case Report A 14-year-old male presented with a history of abdominal distension and pedal edema for 5 months. Physical examination revealed raised jugular venous pulse with normal heart sounds and no murmurs. Transthoracic echocardiography (TTE) revealed constrictive physiology and thickened pericardium. After induction of anesthesia, TEE revealed an irregular hyperechoic mass (50 × 36 × 30 mm) in the RA free wall that was not detected on preoperative TTE and computerized tomography (CT). Thickened pericardium all around mandated limited pericardiectomy under TEE guidance to allow bicaval cannulation for establishing CPB. This was followed by surgical removal of the thrombus and remaining pericardiectomy using CPB. His postoperative period was uneventful and the patient was discharged home on postoperative day 7. Conclusion The TEE may be instrumental in diagnosis of coexistent RA thrombus in the case of CCP resulting in major change in surgical plan and providing perioperative monitoring to avert significant morbidity and mortality. How to cite this article Ganesan R, Kumar B, Munirathinam GK, Bhat I, Mahajan S. Modification in Surgical Plan following Intraoperative Detection of Co-existent Right Atrial Thrombus by Transesophageal Echocardiography in Chronic Constrictive Pericarditis. J Perioper Echocardiogr 2017;5(1):34-37.

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Tumors of the Heart and Great Vessels

Chahinian¹,

Gutstein²,

Fuster³

2017

Holland‐Frei Cancer Medicine

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Overview Primary tumors of the heart and great vessels are rare, but secondary tumors are significantly more common. Clinical manifestations of cardiac tumors depend on the location and size of the mass, not on the histopathology of the tumor. Several noninvasive imaging modalities including echocardiography, cardiac MRI, cardiac CT, and PET are currently available to provide complementary information on the location, extent, and tissue characteristics of a cardiac tumor. The clinical management of patients with cardiac tumors varies based on the type of tumor, clinical symptoms, and overall prognosis.

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Real Time Three‐Dimensional Echocardiography Evaluation of Intracardiac Masses

Cited by 61 publications

References 47 publications

Libman-Sacks Endocarditis: Detection, Characterization, and Clinical Correlates by Three-Dimensional Transesophageal Echocardiography

Libman-Sacks Endocarditis: Detection, Characterization, and Clinical Correlates by Three-Dimensional Transesophageal Echocardiography

Modification in Surgical Plan following Intraoperative Detection of Co-existent Right Atrial Thrombus by Transesophageal Echocardiography in Chronic Constrictive Pericarditis

Tumors of the Heart and Great Vessels

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