Role of modern 3D echocardiography in valvular heart disease

Abstract

Three-dimensional (3D) echocardiography has been conceived as one of the most promising methods for the diagnosis of valvular heart disease, and recently has become an integral clinical tool thanks to the development of high quality real-time transesophageal echocardiography (TEE). In particular, for mitral valve diseases, this new approach has proven to be the most unique, powerful, and convincing method for understanding the complicated anatomy of the mitral valve and its dynamism. The method has been useful for surgical management, including robotic mitral valve repair. Moreover, this method has become indispensable for nonsurgical mitral procedures such as edge to edge mitral repair and transcatheter closure of paravaluvular leaks. In addition, color Doppler 3D echo has been valuable to identify the location of the regurgitant orifice and the severity of the mitral regurgitation. For aortic and tricuspid valve diseases, this method may not be quite as valuable as for the mitral valve. However, the necessity of 3D echo is recognized for certain situations even for these valves, such as for evaluating the aortic annulus for transcatheter aortic valve implantation. It is now clear that this method, especially with the continued development of real-time 3D TEE technology, will enhance the diagnosis and management of patients with these valvular heart diseases.

Role of 3-Dimensional Echocardiography in the Comprehensive Evaluation of the Tricuspid Valve in Patients With Tricuspid Regurgitation

“…1 Although there are still limitations to the currently available 3-D ultrasound methods, especially transthoracic echocardiography (TTE), due to its relatively low image quality and time resolution, the use of the highquality real-time 3-D transesophageal echocardiography (TEE) for such catheter-based treatments is essential for the success of the procedures. 2 With the recognition of the impact of tricuspid regurgitation (TR) on outcome in a number of disease states, interest in understanding this disease process has grown. 3-6…”

Ecocardiografía avanzada: aplicación clínica actual del análisis de deformación miocárdica y de la imagen tridimensional

“…Para la identificación de masas/vegetaciones la vista desde el VI es de mayor utilidad, mientras que para el estudio morfológico y estructural se prefiere el plano obtenido desde la aorta (Shiota 2014). Se ha comprobado que el ETT 2D infraestima el área del TSVI, ya que se calcula presumiendo una estructura circular.…”

Mitral Valve Perforation: The Value of Real Time Three-Dimensional Transesophageal Echocardiography

“…The incidence may be higher than whish had been reported in autopsy studies; around 8-20%. [1] 3-Dimensional TEE plays a key role in the characterization of valvular heart disease, especially, the mitral valve disease [2][3][4]. In spite of high quality of 2-Dimensional TEE, the 3-Dimensional TEE proved to be more accurate to characterize the localization of the anterior mitral leaflet perforation and to exclude mitral valve vegetations than the 2-Dimensional TEE [4,5].…”