Abstract:The use of real-time transthoracic 3DE in endomyocardial right ventricular biopsies in children is both feasible and safe. Further study to determine the impact of real-time 3DE guidance on fluoroscopy and case times for endomyocardial biopsies is warranted.
“…The feasibility and utility of 3D transthoracic echocardiography for guidance of RV endomyocardial biopsies in children has also been demonstrated. 82 Assessment of RV function is of great interest in cardiovascular surgery, because right-sided heart failure is one of the most frequent causes of morbidity and mortality after valvular and congenital surgery, coronary artery bypass, and heart transplantation. This highlights the importance of an accurate preoperative assessment of the right ventricle to improve risk stratification and early and precise postoperative follow-up to optimize treatment.…”
Section: E Clinical Validation and Applicationmentioning
“…The feasibility and utility of 3D transthoracic echocardiography for guidance of RV endomyocardial biopsies in children has also been demonstrated. 82 Assessment of RV function is of great interest in cardiovascular surgery, because right-sided heart failure is one of the most frequent causes of morbidity and mortality after valvular and congenital surgery, coronary artery bypass, and heart transplantation. This highlights the importance of an accurate preoperative assessment of the right ventricle to improve risk stratification and early and precise postoperative follow-up to optimize treatment.…”
Section: E Clinical Validation and Applicationmentioning
“…19 In their experience, the use of live 3DE guidance was associated with no complications, including no new tricuspid valve leaflet flail or pericardial effusion. 19 In their experience, the use of live 3DE guidance was associated with no complications, including no new tricuspid valve leaflet flail or pericardial effusion.…”
Complex intracardiac anatomy and spatial relationships are inherent to congenital heart defects (CHDs). Recognition of the limitations of two-dimensional echocardiography has stimulated clinical interest in three-dimensional imaging. The current review examines contemporary studies in the following areas where three-dimensional echocardiography has provided additive value in CHD: (1) visualization of morphology, (2) quantitation of chamber sizes and ventricular function, and (3) image-guided interventions.
There have been significant advancements in the ability of echocardiography to provide both morphological and functional information in children with congenitally malformed hearts. This progress has come through the development of improved technology such as matrix array probes and software which allows for the off line analysis of images to a high standard. This article focuses on these developments and discusses some newer concepts in advanced echocardiography such is multi-planar reformatting [MPR] and tissue motion annular displacement [TMAD].Our aim is to discuss important aspects related to the quality and reproducibility of data, to review the most recent published data regarding advanced echocardiography in the malformed heart and to guide the reader to appropriate text for overcoming the technical challenges of using these methods. Many of the technical aspects of image acquisition and post processing have been discussed in recent reviews by the authors and we would urge readers to study these texts to gain a greater understanding [1]. The quality of the two dimensional image is paramount in both strain analysis and three dimensional echocardiography. An awareness of how to improve image quality is vital to acquiring accurate and usable data.Three dimensional echocardiography (3DE) is an attempt to visualise the dynamic morphology of the heart. Although published media is the basis for theoretical knowledge of how to practically acquire images, electronic media [eg.] is the only way of visualising the advantages of this technology in real time.It is important to be aware of the limitations of this technology and that much of the data gleaned from using these methods is at a research stage and not yet in regular clinical practice.
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