Use of Real-time 3-dimensional Transthoracic Echocardiography in the Evaluation of Mitral Valve Disease

Sugeng, Lissa; Coon, Patrick D.; Weinert, Lynn; Jolly, Neeraj; Lammertin, Georgeanne; Bednarz, J.; Thiele, Karl; Lang, Roberto M.

doi:10.1016/j.echo.2005.11.016

Cited by 114 publications

(67 citation statements)

References 16 publications

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“…Surface and transesophageal echocardiography (TEE) (including 3D) (online-only Data Supplement Movie 1) may be required to understand mitral valvular and chordal morphology when the direction of the MR jet is not posteriorly directed. 32 Compared with normal controls, studies using 3D CMR have demonstrated a higher frequency of papillary muscle abnormalities (anteroapical displacement and hypermobile bifid papillary muscles) in patients with HCM. 33,34 These patients have a high prevalence of SAM and elevated LV outflow tract (LVOT) gradients independent of septal thickness.…”

Section: Evaluation Of Mitral Valve and Subvalvular Apparatusmentioning

confidence: 98%

Imaging Phenotype Versus Genotype in Hypertrophic Cardiomyopathy

Desai

Ommen

McKenna

et al. 2011

Circ: Cardiovascular Imaging

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H ypertrophic cardiomyopathy (HCM) is a common monogenetic cardiac disease with a prevalence of 0.2% 1 that usually is inherited as an autosomal dominant trait with variable penetrance and expression. Clinically, HCM is defined by the presence of left ventricular (LV) hypertrophy (LVH) unexplained by abnormal loading conditions. 1 The natural history varies from an asymptomatic course to drugrefractory angina/dyspnea, sudden cardiac death (SCD), and end-stage heart failure. The incidence of HCM-related SCD is approximately 1% to 2% in children and adolescents and 0.5% to 1% in adults. 2,3 In this review, we examine the impact of advanced diagnostic imaging technologies on HCM, with particular emphasis on the detection of particular genetic subtypes.

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Section: Evaluation Of Mitral Valve and Subvalvular Apparatusmentioning

confidence: 98%

Imaging Phenotype Versus Genotype in Hypertrophic Cardiomyopathy

Desai

Ommen

McKenna

et al. 2011

Circ: Cardiovascular Imaging

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“…The availability of transthoracic RT3DE technology has enabled real-time volumetric imaging of the mitral valve from the transthoracic approach, the feasibility of which was demonstrated in 70% of consecutive patients, 62 resulting in optimal visualization of both mitral leaflets, commissures, and the orifice. Importantly, the anterior mitral leaflet was visualized better than the posterior leaflet, probably because of its larger size.…”

Section: Rt3de Evaluation Of Valvular Heart Disease Mitral Valvementioning

confidence: 99%

Real-Time 3-Dimensional Echocardiography

2009

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O ne of the most significant developments of the last decade in ultrasound imaging of the heart was the evolution of 3-dimensional (3D) imaging from slow and labor-intense offline reconstruction to real-time volumetric imaging. This imaging modality provides valuable clinical information that empowers echocardiographers with new levels of confidence in the diagnosis of heart disease. We have previously described the technological milestones in the development of real-time 3D echocardiographic (RT3DE) imaging and its major advantages over conventional 2-dimensional echocardiography (2DE) and reviewed the published literature that supported the use of this new methodology in clinical practice. 1 Since 2006, the growing availability of RT3DE technology, its ease of use, and its multiple attractive features have sparked significant interest in the research community, resulting in a large number of publications, most of which have endorsed RT3DE imaging for clinical use by demonstrating its unique capabilities in different scenarios. In parallel, the clinical acceptance of this new tool has broadened significantly. The most recent clinically significant addition is matrix-array transesophageal echocardiography (TEE), which provides images of unprecedented quality that aid surgeons and interventional cardiologists in planning and guiding procedures and evaluating their outcomes.The purpose of the present article is to review the most recent RT3DE literature and provide readers with an update on the latest developments and the current status of this noninvasive imaging tool. Because different potential applications of RT3DE imaging have been explored to various extents, they are described here separately, and each is discussed with an emphasis on the scientifically established facts, along with the known stumbling blocks and difficulties. Quantification of LV Volumes and FunctionA firmly established advantage of 3D imaging over crosssectional slices of the heart is the improvement in the accuracy of the evaluation of left ventricular (LV) volumes and ejection fraction (EF) by eliminating the need for geometric modeling, which is inaccurate in the presence of aneurysms, asymmetrical ventricles, or wall motion abnormalities, and the errors caused by foreshortened views even in symmetrical ventricles. The value of RT3DE imaging in this context has been demonstrated by multiple studies that compared RT3DE volume measurements with widely accepted reference techniques, including radionuclide ventriculography and cardiac magnetic resonance (CMR). [2][3][4][5][6] These studies and others have demonstrated higher levels of agreement between the RT3DE approach and the respective reference technique compared with conventional 2DE methodology. Additionally, RT3DE measurements were found to be more reproducible than 2DE 4,5,7 and, in some studies, even as reproducible as CMR. 8 Interestingly, in a recent study in patients after myocardial infarction (MI), 9 RT3DE-derived LV volumes were more accurate and more reproducible than thos...

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“…Imaging using 3DE has been widely used to visualize the anatomy in the various lesions and to assess cardiac function and volume for quantification [1][2][3][4][5][6][7][8].…”

Section: Discussionmentioning

confidence: 99%

“…Transthoracic 3DE for understanding intracardiac anatomy in various congenital heart diseases has been reported to be of clinical use in evaluation of mitral valve disease and structure [1,2], the structural and dynamic recognition of discrete subaortic stenosis [3], visualization of ventricular septal defects [4] and atrial septal defects [6], and the diagnosis of complex congenital heart disease.…”

Section: Discussionmentioning

confidence: 99%

Pericardial Three-dimensional Echocardiography

Kajimura¹,

Satomi²,

Yasukochi³

et al. 2008

J Echocardiogr

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Background. Transthoracic real-time 3-dimensional echocardiography (3DE) is useful for understanding anatomical structure in planning surgical procedures for treatment of congenital heart disease, but the image resolution has not reached a level that is sufficient to show the detailed anatomy required by surgeons, due to limitations in the width of the acoustic window and ultrasonic penetration. To improve the image quality, we applied the transpericardial approach to obtain the 3DE images and compared these images to those of the surgical findings.Methods. The study included 22 consecutive patients with congenital heart disease who underwent various surgical procedures and were imaged with transpericardial 3DE just before surgery, using a Philips iE33 system with an X3-1 probe (10 cases) or an X7-2 probe (12 cases)(Philips Medical Systems Inc. Andover, MA, USA). The 3D anatomical echocardiographic images were acquired by a pericardial approach and reconstructed using an off-line computer system (QLAB, Philips Med. Inc. Andover, MA, USA). Then these reconstructed 3DE images were compared to the intraoperative findings and the pictures taken during the operation.Results. Moving 3D images in a cardiac cycle were successfully reconstructed in all cases within 10 minutes. All intracardiac anatomy identified in each 3DE image corresponded to those seen in direct observation of the intracardiac structure. In one case with a double outlet right ventricle with subpulmonary ventricular septal defect (VSD), precise delineation of the spatial relationship between the great arteries and a VSD enabled simulation of the surgical procedure for placement of a patch to close the VSD.Conclusions. Transpericardial 3DE is a powerful diagnostic method to yield high quality real-time images equivalent enough to the surgical findings. (J Echocardiogr 2008; 6: 39-45)

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Use of Real-time 3-dimensional Transthoracic Echocardiography in the Evaluation of Mitral Valve Disease

Cited by 114 publications

References 16 publications

Imaging Phenotype Versus Genotype in Hypertrophic Cardiomyopathy

Imaging Phenotype Versus Genotype in Hypertrophic Cardiomyopathy

Real-Time 3-Dimensional Echocardiography

Pericardial Three-dimensional Echocardiography

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