Real Time Three‐Dimensional Transesophageal Echocardiography for Guiding Percutaneous Mitral Valvuloplasty

Abstract

A 50-year-old woman with symptomatic moderate mitral valve stenosis of rheumatic origin and mild mitral regurgitation underwent percutaneous mitral valvuloplasty (PMV). The Wilkins score of the mitral valve was 8, with minimal calcification of the valve and subvalvular apparatus, commissural fusion, moderate thickening of the leaflets, and moderate reduction of its mobility. Mitral valve area determined by pressure half-time method, by proximal isovelocity surface area method and by direct planimetry using real time threedimensional transesophageal echocardiograFigure 1. RT3D-TEE. The catheter for transseptal approach crosses the interatrial septum with the distal end in the left atrium (upper side of the image). LA = left atrium; RA = right atrium; long arrow = interatrial septum; short arrow = distal end of the catheter.

Three-dimensional Echocardiography

“…As a result the hemispheric PISA method has been [14] found significant underestimation of the EROA determined using the conventional hemispheric PISA method compared to the EROA measured by hemielliptic PISA, particularly in patients with MVP and functional MR. Hemielliptic PISA can be obtained from RT3DE datasets using PISA width, length, and radius for the calculation of the hemielliptic PISA surface by a hemielliptic formula (. 7 [102] or investigated computer simulations for semi-automated 3D reconstruction of PISA [103] and found significantly improved accuracy of 3D 7 [102] or investigated computer simulations for semi-automated 3D reconstruction of PISA [103] and found significantly improved accuracy of 3D…”

“….31) [61][102]. RT3D TEE is a suitable technique for monitoring percutaneous mitral valvuloplasty and provides accurate measurement of MVA immediately after PMV.…”

Valvular heart disease – stenoses

“…In recent years, RT3D TEE has become a valuable complementary tool guiding PMV [28][29]30] and accurately managing and diagnosing possible complications. Real-time 3DTEE supplies superior imaging quality and is capable of facilitating interventions with unprecedented detail and ease (see 7 Fig.…”