Three-Dimensional Echo for the Assessment of Valvular Heart Disease

Mumm, Bernhard; Baumann, Rolf; Hyca, Martin

doi:10.1016/j.ccl.2007.06.002

Cited by 8 publications

(2 citation statements)

References 28 publications

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“…However, 3-dimensional echocardiography (3DE) was introduced recently into clinical practice and may provide complementary information and improve quantitative accuracy and reproducibility compared to 2D techniques. 25 Hence, we could not incorporate data from 3DE into the study because data was collected between 2001 and 2005 and 3DE had not yet been introduced into clinical practice in our department.…”

Section: Discussionmentioning

confidence: 99%

Isolated Cleft in the Posterior Mitral Valve Leaflet: A Congenital Form of Mitral Regurgitation

Wyss

Enseleit

Loo

et al. 2009

Clinical Cardiology

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Background: Isolated congenital cleft of the posterior leaflet of the mitral valve is a rare cause of mitral regurgitation (MR). This study describes the clinical, echocardiographic, and intraoperative findings as well as treatment options. Methods: Adults with an isolated cleft of the posterior mitral valve leaflet diagnosed by transthoracic echocardiography were evaluated with respect to clinical, echocardiographic, preoperative and intraoperative findings, and different surgical strategies. Results: The prevalence of isolated cleft of the posterior mitral valve leaflet in all patients examined was 0.11% (n = 22 out of 19 320 evaluated echocardiograms); male gender was predominant (73%). Dyspnea on exertion was present in almost all patients with at least moderate regurgitation. The predominant localization of the cleft was within segment P2 (59%), followed by a cleft between P1/P2 (18%). An isolated cleft in segment P3 or segment P1 occurred twice in each segment (n = 2; 9%) and between P2/P3 once (n = 1; 5%). Regurgitation was severe in 50% (n = 11), moderate in 9% (n = 2), mild in 27% (n = 6), and only trivial in 14% (n = 3) of the patients. Surgical treatment involved reconstruction with ring annuloplasty in 45% (n = 10) and replacement in 4.5% (n = 1). A total of 11 patients (50%) with mostly mild or trivial mitral regurgitation were treated medically only. Conclusion: Two-dimensional high-resolution cross-sectional echocardiography allows the distinct diagnosis of a clefted posterior leaflet, whereas clinical presentation, electrocardiogram, chest x-ray, and angiography are failing to identify the correct etiology of MR in patients with isolated posterior leaflet cleft mitral valve (IPLCMV). Patients with moderate to severe MR were treated surgically with excellent outcome.

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Section: Discussionmentioning

confidence: 99%

Isolated Cleft in the Posterior Mitral Valve Leaflet: A Congenital Form of Mitral Regurgitation

Wyss

Enseleit

Loo

et al. 2009

Clinical Cardiology

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“…The mitral valve (MV) is the cardiac structure that has been most extensively studied using 3D echocardiography [42]. Because of its nonplanar, saddle-shaped form, it serves as the ideal example of the advantages of 3D visualization.…”

Section: Mitral Valvementioning

confidence: 99%

3D Echocardiography

Meijboom

Bosch

McGhie

2009

Echocardiography in Pediatric and Congenital Heart Disease

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About 30 years ago, clinical echocardiography started with B-mode. The dot jumping up and down on the monitor was difficult to interpret. M-mode was the next step, with a time axis added to the B-mode. Two-dimensional (2D) echocardiography was the next leap forward in noninvasive cardiac assessment. Currently 2D imaging is the core of every echocardiographic examination, together with M-mode, pulsed Doppler, continuous-wave Doppler and color Doppler. In pediatric cardiology, the assessment of sometimes complex anatomy is the major task for the echocardiographer. Using current 2D imaging techniques, an experienced cardiologist can accurately diagnose most congenital malformations. However, 2D imaging has several limitations. Firstly, the quantification of ventricular volumes and function requires geometrical assumptions that are reasonable for normal left ventricles but are often inaccurate for dilated and structurally abnormal hearts. 3D echo could obviate the need for these assumptions, as the entire ventricle can be visualized during the cardiac cycle and ventricular volumes can be measured. The first manuscript on this application of 3D echocardiography was published in 1974 [1]. Secondly the anatomy of congenital heart defects is often so complex that conceptualization of the true "surgical" anatomy out of a series of 2D cut-planes through the heart is often difficult. Transesophageal echo (TEE) can sometimes lead to a better understanding of the intracardiac anatomy due to better image resolution and the possibility of paraplane imaging (cutting through intracardiac structures at different levels) and anyplane imaging (cutting through intracardiac structures at different angles), but it remains essentially a 2D technique. A clear presentation of true anatomy, instead of a conceptualized 3D image in each operator's head, would make discussion about the interpretation of echocardiographic studies more objective. 3D echocardiography allows visualization of 3D relationships instead of having to conceptualize them mentally. These two reasons explain why so much effort was put into developing 3D imaging techniques [2]. History of 3D imaging techniquesIn the early phase of 3D echo, a 3D dataset was created by merging individual 2D cross-sections, obtained at different levels or from different angles [3,4]. The first technique was "freehand scanning:" multiple 2D scanning planes were obtained manually, with the help of an external reference system for the transducer position. The transducer position could be determined with a mechanical arm or with sensors (optical or electrical). In experimental settings the results were promising regarding volumetric data, but the procedure was very time-consuming, suffered from many artifacts and had poor resolution. The second technique used internal reference systems for the acquisition of the cut-planes, and systematic image acquisition was achieved by means of a predetermined transducer motion. This preprogrammed motion of the transducer was linear, fanlike or rotational. It ...

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Echocardiographic Assessment of Native Valve Function

Peterson

Forbess

2009

Valvular Heart Disease

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Three-Dimensional Echo for the Assessment of Valvular Heart Disease

Cited by 8 publications

References 28 publications

Isolated Cleft in the Posterior Mitral Valve Leaflet: A Congenital Form of Mitral Regurgitation

Isolated Cleft in the Posterior Mitral Valve Leaflet: A Congenital Form of Mitral Regurgitation

3D Echocardiography

Echocardiographic Assessment of Native Valve Function

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