The Evaluation of Real-time 3-Dimensional Transthoracic Echocardiography for the Preoperative Functional Assessment of Patients with Mitral Valve Prolapse: A Comparison with 2-Dimensional Transesophageal Echocardiography

Sharma, Rajan; Mann, Jon; Drummond, Linda; Livesey, Steven; Simpson, Iain

doi:10.1016/j.echo.2007.01.028

Cited by 53 publications

(23 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…69 A recent study compared segmental analysis of mitral prolapse from transthoracic RT3DE images against TEE findings and found that these 2 techniques yield similar comparative accuracy for precise anatomic localization of prolapsing mitral valve segments. 70,71 Interestingly, the study by De Castro and colleagues 72 reported higher concordance between 3D TEE and surgery than 2D TEE in the evaluation of prolapsing mitral valve scallops. The diagnostic accuracy of RT3DE evaluation of functional anatomy of mitral regurgitation also was demonstrated recently against surgical findings.…”

Section: Mor-avi Et Almentioning

confidence: 99%

Real-Time 3-Dimensional Echocardiography

2009

View full text Add to dashboard Cite

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...

show abstract

Section: Mor-avi Et Almentioning

confidence: 99%

Real-Time 3-Dimensional Echocardiography

2009

View full text Add to dashboard Cite

show abstract

“…New applications of 2D-TOE have been developed in the last decade, including the pre-and post-operative evaluation of several surgical interventions and, specifically, 2D-TOE is considered fundamental for the evaluation of valve repair and replacement [1][2][3][4]. Multiplane 2D-TOE, introduced in the early 90s, has significantly improved transoesophageal imaging during cardiac surgery [5,6] and, more recently, the usefulness of three-dimensional (3D) echocardiography (based on rotational acquisition with a multiplane probe) has been demonstrated in selected pathologies [7][8][9][10][11]. A new generation of transoesophageal probes with a novel matrix array transducer has been recently introduced, allowing 3D representation of cardiac structures in real-time [12][13][14][15][16][17][18][19][20].…”

Section: Introductionmentioning

confidence: 99%

Real-time three-dimensional transoesophageal echocardiography: a new intraoperative feasible and useful technology in cardiac surgery

Gripari

Tamborini

Barbier

et al. 2010

Int J Cardiovasc Imaging

View full text Add to dashboard Cite

A new generation of transoesophageal echocardiographic probes with a novel matrix array technique has been recently introduced, allowing three-dimensional (3D) presentation of cardiac structures in real-time. This new tool may potentially provide fast and complete 3D information about cardiac structures improving spatial orientation and overcoming limitations of offline 3D technologies. The aim of this study was to demonstrate the feasibility and usefulness of real-time 3D transoesophageal echocardiography (TOE) for the intraoperative evaluation of cardiac surgery procedures. One-hundred patients underwent transoesophageal echocardiographic examination during cardiac surgery as a part of their routine clinical practice. In the intraoperative pre- and post-cardiopulmonary bypass periods complete 2D and 3D transoesophageal examinations were performed. Feasibility and duration of examinations, and immediate additional anatomical value of 3D versus 2D-TOE were annotated intraoperatively. Image quality, additional clinical value of 3D- compared to standard 2D-TOE and the accuracy in the description of mitral valve pathology by a surgeon and an echocardiographer were evaluated off-line. No complications related to transoesophageal examination occurred and successful intubation was achieved in all 100 patients. Therefore, 200 examinations were performed and analysed considering the pre- and post-cardiopulmonary bypass periods. The mean number of acquisitions per patient was 16 +/- 14, including 3D real-time, zoom, full-volume and colour full volume modalities. The duration of the 3D examination was 16 +/- 10 min and the mean image quality score 2.8 +/- 0.7 (in a scale 1-4). In 36 out of 100 cases (36%) 3D-TOE provided additional anatomical information. The surgeon evaluated 3D images easier and more accurately than 2D images (88% vs. 76% in the evaluation of mitral valve scallop). Real-time 3D TOE may be used routinely for the intraoperative evaluation of cardiac surgery. Imaging with this new probe facilitates intraoperative evaluation of several surgical procedures with an additional clinical value in selected cases.

show abstract

“…3D TTE-guided direct planimetry of the VC cross-sectional area, measurements using the PISA method, and volumetric assessment of EROA have all been compared to 2D echocardiography and shown to be accurate regardless of MR etiology or orifice shape [29][30][31]. In patients with MVP, 3D TTE provides reliable data regarding anatomic localization of prolapsing scallops with accuracy comparable to that provided by 2D TEE and overall allows better spatial localization of commissures and valvular pathology [32]. & 3D TEE provides a distinct advantage over 2D TEE because of its ability to visualize the entire MV apparatus with more detail.…”

Section: D Echocardiographymentioning

confidence: 96%

Assessment of Mitral Valve Disease: A Review of Imaging Modalities

Motiwala

Delling

2015

Curr Treat Options Cardio Med

View full text Add to dashboard Cite

Mitral valve disease (MVD) related to mitral valve prolapse (MVP), coronary artery disease (CAD), and calcific mitral stenosis, is increasing in prevalence across the USA and Europe in the context of a longer life expectancy and aging population. In developing countries, rheumatic heart disease remains a major cause of MVD. Echocardiography represents the primary diagnostic modality for assessment of the mitral valve (MV). With the implementation of three-dimensional imaging, echocardiography has become an indispensable tool to evaluate the morphology, geometry, and function of the MV apparatus in the pre-operative setting. However, recognition of its limitations and advances in newer technologies have led to a growing interest in other imaging modalities such as cardiac magnetic resonance (CMR). Although still not widely available, CMR is an essential complement to echocardiography, especially when poor image quality, significant variability in flow diameter measurements, and geometric assumptions of flow orifice preclude accurate quantification of mitral regurgitation on echocardiographic images. In addition, CMR can reliably provide quantitative determination of ventricular volumes and function, hence facilitating surgical decision-making when serial linear echocardiographic measurements are discrepant. Finally, CMR assessment of fibrosis using late gadolinium enhancement allows better understanding of the interactions between MVD and the myocardium in both MVP and MVD related to CAD or other myopathy. In this review, we summarize the role of the available imaging modalities in understanding valvular pathology and determining severity of regurgitation or stenosis. Recently published valvular guidelines highlight the importance of monitoring MVD progression and the shift to intervention earlier in the course of disease. In this context, we also discuss the potential role of echocardiography and CMR in identifying early stages of MVD and/or pre-clinical markers of myocardial dysfunction.

show abstract

The Evaluation of Real-time 3-Dimensional Transthoracic Echocardiography for the Preoperative Functional Assessment of Patients with Mitral Valve Prolapse: A Comparison with 2-Dimensional Transesophageal Echocardiography

Cited by 53 publications

References 25 publications

Real-Time 3-Dimensional Echocardiography

Real-Time 3-Dimensional Echocardiography

Real-time three-dimensional transoesophageal echocardiography: a new intraoperative feasible and useful technology in cardiac surgery

Assessment of Mitral Valve Disease: A Review of Imaging Modalities

Contact Info

Product

Resources

About