51
|
Slipczuk L, Siegel RJ, Jilaihawi H, Hussaini A, Kar S. Optimizing procedural outcomes in percutaneous mitral valve therapy using transesophageal imaging: a stepwise analysis. Expert Rev Cardiovasc Ther 2014; 10:901-16. [DOI: 10.1586/erc.12.72] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
52
|
Gripari P, Muratori M, Fusini L, Tamborini G, Pepi M. Three-Dimensional Echocardiography: Advancements in Qualitative and Quantitative Analyses of Mitral Valve Morphology in Mitral Valve Prolapse. J Cardiovasc Echogr 2014; 24:1-9. [PMID: 28465897 PMCID: PMC5353406 DOI: 10.4103/2211-4122.131985] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Degenerative mitral valve disease (MVD) is the leading cause of organic mitral regurgitation (MR), one of the most common valvular heart disease in western countries. Substantial progresses in the surgical treatment of degenerative MVD have improved life expectancy of patients with significant MR. However, prognosis, surgical decision and timing of surgery strongly depend on the accurate characterization of mitral valve (MV) anatomy and pathology and on the precise quantification of MR. Three-dimensional (3D) echocardiography, a major technological breakthrough in the field of cardiovascular imaging, provides several advantages over two-dimensional (2D) imaging in the qualitative and quantitative evaluations of MV apparatus. In this review, we focus on the contribution of this new modality to the diagnosis of degenerative MVD, the quantitative assessment of MR severity, the selection and monitoring of surgical and percutaneous procedures, the evaluation of procedural outcomes. The results of a systematic and exhaustive search of the existing literature, restricted to real-time 3D echocardiography in adults, are here reported.
Collapse
Affiliation(s)
- Paola Gripari
- Centro Cardiologico Monzino, Istituto di ricovero e cura a carattere scientifico, Milano, Italy
| | - Manuela Muratori
- Centro Cardiologico Monzino, Istituto di ricovero e cura a carattere scientifico, Milano, Italy
| | - Laura Fusini
- Centro Cardiologico Monzino, Istituto di ricovero e cura a carattere scientifico, Milano, Italy
| | - Gloria Tamborini
- Centro Cardiologico Monzino, Istituto di ricovero e cura a carattere scientifico, Milano, Italy
| | - Mauro Pepi
- Centro Cardiologico Monzino, Istituto di ricovero e cura a carattere scientifico, Milano, Italy
| |
Collapse
|
53
|
Jánosi RA, Plicht B, Kahlert P, Eißmann M, Wendt D, Jakob H, Erbel R, Buck T. Quantitative Analysis of Aortic Valve Stenosis and Aortic Root Dimensions by Three-Dimensional Echocardiography in Patients Scheduled for Transcutaneous Aortic Valve Implantation. CURRENT CARDIOVASCULAR IMAGING REPORTS 2014; 7:9296. [PMID: 25506408 PMCID: PMC4260114 DOI: 10.1007/s12410-014-9296-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/29/2022]
Abstract
Accurate assessment of the aortic valve area (AVA) and evaluation of the aortic root are important for clinical decision-making in patients being considered for transcatheter aortic valve implantation (TAVI). Real-time three-dimensional transesophageal echocardiography (RT3D-TEE) provides accurate and reliable quantitative assessment of aortic valve stenosis and the aortic root. We performed two-dimensional transthoracic echocardiography (2D-TTE), real-time 2D transesophageal echocardiography (RT2D-TEE) and RT3D-TEE in 71 consecutive patients referred for TAVI. RT3D-TEE multiplanar reconstruction was used to measure aortic root parameters, including left ventricular outflow tract (LVOT) diameter and area, aortic annulus diameter, aortic annulus area, and AVA. RT3D-TEE methods for planimetry and the LVOT-derived continuity equation for the estimation of AVA showed a good correlation. As iatrogenic coronary ostium occlusion is a potentially life-threatening complication, we evaluated the distances from the aortic annulus to the coronary ostia using RT3D-TEE. Based on our findings, we conclude that the geometry of the aortic root and aortic valve can be reliably and feasibly evaluated using RT3D-TEE, which is important for protecting against potential complications of TAVI, such as underestimation of the size of the aortic annulus that can result in aortic regurgitation and dislocation of the valve, or overestimation can lead to annulus rupture.
Collapse
Affiliation(s)
- Rolf Alexander Jánosi
- />Department of Cardiology, West-German Heart and Vascular Center, University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45122 Essen, Germany
| | - Björn Plicht
- />Department of Cardiology, Klinikum Westfalen Dortmund, Dortmund, Germany
| | - Philipp Kahlert
- />Department of Cardiology, West-German Heart and Vascular Center, University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45122 Essen, Germany
| | - Mareike Eißmann
- />Department of Cardiology, West-German Heart and Vascular Center, University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45122 Essen, Germany
| | - Daniel Wendt
- />Department of Thoracic and Cardiovascular Surgery, West-German Heart and Vascular Center Essen, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Heinz Jakob
- />Department of Thoracic and Cardiovascular Surgery, West-German Heart and Vascular Center Essen, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Raimund Erbel
- />Department of Cardiology, West-German Heart and Vascular Center, University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45122 Essen, Germany
| | - Thomas Buck
- />Department of Cardiology, Klinikum Westfalen Dortmund, Dortmund, Germany
| |
Collapse
|
54
|
Addetia K, Mor-Avi V, Weinert L, Salgo IS, Lang RM. A New Definition for an Old Entity: Improved Definition of Mitral Valve Prolapse Using Three-Dimensional Echocardiography and Color-Coded Parametric Models. J Am Soc Echocardiogr 2014; 27:8-16. [DOI: 10.1016/j.echo.2013.08.025] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2013] [Indexed: 12/22/2022]
|
55
|
Pouch AM, Wang H, Takabe M, Jackson BM, Gorman JH, Gorman RC, Yushkevich PA, Sehgal CM. Fully automatic segmentation of the mitral leaflets in 3D transesophageal echocardiographic images using multi-atlas joint label fusion and deformable medial modeling. Med Image Anal 2014; 18:118-29. [PMID: 24184435 PMCID: PMC3897209 DOI: 10.1016/j.media.2013.10.001] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2012] [Revised: 09/18/2013] [Accepted: 10/02/2013] [Indexed: 10/26/2022]
Abstract
Comprehensive visual and quantitative analysis of in vivo human mitral valve morphology is central to the diagnosis and surgical treatment of mitral valve disease. Real-time 3D transesophageal echocardiography (3D TEE) is a practical, highly informative imaging modality for examining the mitral valve in a clinical setting. To facilitate visual and quantitative 3D TEE image analysis, we describe a fully automated method for segmenting the mitral leaflets in 3D TEE image data. The algorithm integrates complementary probabilistic segmentation and shape modeling techniques (multi-atlas joint label fusion and deformable modeling with continuous medial representation) to automatically generate 3D geometric models of the mitral leaflets from 3D TEE image data. These models are unique in that they establish a shape-based coordinate system on the valves of different subjects and represent the leaflets volumetrically, as structures with locally varying thickness. In this work, expert image analysis is the gold standard for evaluating automatic segmentation. Without any user interaction, we demonstrate that the automatic segmentation method accurately captures patient-specific leaflet geometry at both systole and diastole in 3D TEE data acquired from a mixed population of subjects with normal valve morphology and mitral valve disease.
Collapse
Affiliation(s)
- A M Pouch
- Department of Bioengineering, University of Pennsylvania, Philadelphia, PA, United States; Gorman Cardiovascular Research Group, University of Pennsylvania, Philadelphia, PA, United States.
| | | | | | | | | | | | | | | |
Collapse
|
56
|
Maffessanti F, Tamborini G, Fusini L, Stevanella M, Sotaquira M, Caiani E, Pepi M. Advances in echocardiography: insights into the mitral valve and implications for surgical and percutaneous repair. Interv Cardiol 2013. [DOI: 10.2217/ica.13.50] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
|
57
|
Maffessanti F, Mirea O, Tamborini G, Pepi M. Three-dimensional echocardiography of the mitral valve: lessons learned. Curr Cardiol Rep 2013; 15:377. [PMID: 23686753 DOI: 10.1007/s11886-013-0377-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Three-dimensional echocardiography has markedly improved our understanding of normal and pathologic mitral valve (MV) mechanics. Qualitative and quantitative analysis of three-dimensional (3D) data on the mitral valve could have a clinical impact on diagnosis, patient referral, surgical strategies, annuloplasty ring design and evaluation of the immediate and long-term surgical outcome. This review covers the contribution of 3D echocardiography in the diagnosis of MV disease, its role in selecting and monitoring surgical procedures, and in the assessment of surgical outcomes. Moreover, advantages of this technique versus the standard 2D modality, as well as future applications of advanced analysis techniques, will be reviewed.
Collapse
|
58
|
Hien MD, Großgasteiger M, Weymann A, Rauch H, Rosendal C. Reproducibility in Echocardiographic Two- and Three-Dimensional Mitral Valve Assessment. Echocardiography 2013; 31:311-7. [DOI: 10.1111/echo.12365] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Affiliation(s)
- Maximilian Dominik Hien
- Department of Anesthesiology; University of Heidelberg; Heidelberg Germany
- Department of Pediatrics; University of Heidelberg; Heidelberg Germany
- Research Training Group 1126; German Research Foundation (DFG), Bonn; Germany
| | - Manuel Großgasteiger
- Department of Anesthesiology; University of Heidelberg; Heidelberg Germany
- Research Training Group 1126; German Research Foundation (DFG), Bonn; Germany
| | - Alexander Weymann
- Department of Cardiac Surgery; Heart Center; University of Heidelberg; Heidelberg Germany
| | - Helmut Rauch
- Department of Anesthesiology; University of Heidelberg; Heidelberg Germany
| | | |
Collapse
|
59
|
Anwar AM, Nosir YFM, Alasnag M, Chamsi-Pasha H. Real time three-dimensional transesophageal echocardiography: a novel approach for the assessment of prosthetic heart valves. Echocardiography 2013; 31:188-96. [PMID: 23937618 DOI: 10.1111/echo.12327] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVES To explore our initial experience with real time three-dimensional transesophageal echocardiography (RT3DTEE) for the assessment of prosthetic valves (PV). METHODS The study included 40 patients (mean age 35 ± 8.5 years, 68% male) who underwent PV implant. Fifty PV (34 bioprosthetic and 16 mechanical) were evaluated using two-dimensional (2D)TEE and RT3DTEE to rule out PV dysfunction. RESULTS In all patients, RT3DTEE allowed good and simultaneous visualization of PV leaflets. Ten patients had normal functioning PV (5 in mitral, 3 in aortic, and 2 in tricuspid positions). Infective endocarditis was evident in 13 patients (20 PV) by repeated 2DTEE. RT3DTEE confirmed the 2DTEE diagnosis of endocarditis in same patients. Clear delineation of vegetations (size, site, and number) was obtained from RT3DTEE full volume while the vegetation attachment, consistency, mobility and its relation to valve structure were obtained using zoom 3D. Paraaortic abscesses size, site, extension, wall thickness of the abscess could be identified by RT3DTEE in 7 PV. Through cropping of the full-volume 3D images, the orifice of communication between the abscess cavity and aorta could be visualized well in en face view. Color full-volume allowed the detection of paravalvular regurgitation (size, location, direction, and extent) in 8 patients. In the 18 PV who underwent redo surgery, the intra-operative findings confirmed the RT3DTEE description of PV lesions. CONCLUSION Real time 3DTEE improved the anatomical and functional assessment of PV with better understanding of the underlying causes of PV dysfunction; hence, it could improve the management planning for such patients.
Collapse
Affiliation(s)
- Ashraf M Anwar
- Department of Cardiology, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia; Department of Cardiology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | | | | | | |
Collapse
|
60
|
Hien MD, Großgasteiger M, Rauch H, Weymann A, Bekeredjian R, Rosendal C. Experts and Beginners Benefit from Three-Dimensional Echocardiography: A Multicenter Study on the Assessment of Mitral Valve Prolapse. J Am Soc Echocardiogr 2013; 26:828-34. [DOI: 10.1016/j.echo.2013.04.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2012] [Indexed: 10/26/2022]
|
61
|
Sasaki S, Watanabe H, Shibayama K, Mahara K, Tabata M, Fukui T, Tobaru T, Takanashi S, Sumiyoshi T, Tomoike H. Three-Dimensional Transesophageal Echocardiographic Evaluation of Coronary Involvement in Patients with Acute Type A Aortic Dissection. J Am Soc Echocardiogr 2013; 26:837-45. [DOI: 10.1016/j.echo.2013.05.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2012] [Indexed: 11/26/2022]
|
62
|
Ferreira RG, Choi YS, Mackensen GB. Evolving Role of Three-Dimensional Echocardiography in the Cardiac Surgical Patient. CURRENT ANESTHESIOLOGY REPORTS 2013. [DOI: 10.1007/s40140-013-0025-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
63
|
Echocardiography in the era of multimodality cardiovascular imaging. BIOMED RESEARCH INTERNATIONAL 2013; 2013:310483. [PMID: 23878804 PMCID: PMC3708397 DOI: 10.1155/2013/310483] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/11/2013] [Accepted: 06/11/2013] [Indexed: 12/17/2022]
Abstract
Echocardiography remains the most frequently performed cardiac imaging investigation and is an invaluable tool for detailed and accurate evaluation of cardiac structure and function. Echocardiography, nuclear cardiology, cardiac magnetic resonance imaging, and cardiovascular-computed tomography comprise the subspeciality of cardiovascular imaging, and these techniques are often used together for a multimodality, comprehensive assessment of a number of cardiac diseases. This paper provides the general cardiologist and physician with an overview of state-of-the-art modern echocardiography, summarising established indications as well as highlighting advances in stress echocardiography, three-dimensional echocardiography, deformation imaging, and contrast echocardiography. Strengths and limitations of echocardiography are discussed as well as the growing role of real-time three-dimensional echocardiography in the guidance of structural heart interventions in the cardiac catheter laboratory.
Collapse
|
64
|
The Role of 3-Dimensional Echocardiography in the Diagnosis and Management of Mitral Valve Disease. Cardiol Clin 2013; 31:203-15. [DOI: 10.1016/j.ccl.2013.03.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
|
65
|
Kang WS, Choi JW, Kang JE, Chung JW, Kim SH. Determination of mitral valve area with echocardiography, using intra-operative 3-dimensional versus intra- & post-operative pressure half-time technique in mitral valve repair surgery. J Cardiothorac Surg 2013; 8:98. [PMID: 23594408 PMCID: PMC3642013 DOI: 10.1186/1749-8090-8-98] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2012] [Accepted: 04/15/2013] [Indexed: 01/27/2023] Open
Abstract
Background We hypothesized that mitral valve areas (MVAs) with echocardiography, using 3D planimetry technique (measured at one point at maximal opening of mitral valve) versus pressure half-time technique (PHT, measured during entire diastolic phase) in mitral valve repair surgery (MVR) would be different. Methods Patients who had undergone MVR were retrospectively reviewed, and two different observers measured the MVAs using PHT and 3D planimetry technique. The MVAs derived from recorded medical data, using PHT and 3D planimetry technique were abbreviated to MVA-PHT1 and MVA-3D1, and data from the PHT and 3D planimetry techniques by observer A and observer B were determined as MVA-PHT2 and MVA-3D2, and MVA-PHT3 and MVA-3D3, respectively. The MVA derived by post-operative transthoracic echocardiography using the PHT technique was determined as MVA-TTE. Results Intraclass correlation coefficients were 0.90 for the intra-operative PHT technique and 0.78 for the intra-operative 3D planimetry technique. MVA-3D1 (2.91 ± 0.65 cm2), MVA-3D2 (3.00 ± 0.63 cm2) and MVA-3D3 (2.97 ± 0.88 cm2) were significantly larger than MVA-TTE (2.40 ± 0.59 cm2), but intra-operative MVAs-PHT were not. The biases and precisions were larger, and the correlation coefficients were lower in 3D planimetry technique compared with PHT technique. Conclusions MVA measured by 3D planimetry technique with TEE at the intra-operative post-MVR period was seemed to be larger than that measured by the PHT technique with TTE at the post-operative period. However, it did not mean that the 3D planimetry technique was inaccurate but needs cautions at determination of MVA using different techniques.
Collapse
|
66
|
Bhave NM, Addetia K, Spencer KT, Weinert L, Jeevanandam V, Lang RM. Localizing Mitral Valve Perforations With 3D Transesophageal Echocardiography. JACC Cardiovasc Imaging 2013; 6:407-10. [DOI: 10.1016/j.jcmg.2012.11.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2012] [Revised: 11/09/2012] [Accepted: 11/15/2012] [Indexed: 11/24/2022]
|
67
|
Ottaviano L, Chierchia GB, Bregasi A, Bruno N, Antonelli A, Alsheraei A, Porrini A, Gronda E, Donatelli F, Duijnhower AL, Brugada P, Montenero AS. Cryoballoon ablation for atrial fibrillation guided by real-time three-dimensional transoesophageal echocardiography: a feasibility study. ACTA ACUST UNITED AC 2013; 15:944-50. [DOI: 10.1093/europace/eus431] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
68
|
Faletra FF, Pedrazzini G, Pasotti E, Petrova I, Drasutiene A, Dequarti MC, Muzzarelli S, Moccetti T. Role of real-time three dimensional transoesophageal echocardiography as guidance imaging modality during catheter based edge-to-edge mitral valve repair. Heart 2013; 99:1204-15. [DOI: 10.1136/heartjnl-2012-302527] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
|
69
|
Hien MD, Rauch H, Lichtenberg A, De Simone R, Weimer M, Ponta OA, Rosendal C. Real-Time Three-Dimensional Transesophageal Echocardiography. Anesth Analg 2013; 116:287-95. [DOI: 10.1213/ane.0b013e318262e154] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
|
70
|
Skubas NJ, Shernan SK. Intraoperative 3-dimensional echocardiography for mitral valve surgery: just pretty pictures or ready for prime time? Anesth Analg 2013; 116:272-5. [PMID: 23340747 DOI: 10.1213/ane.0b013e318279b5e6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
|
71
|
Binder RK, Webb JG. Percutaneous Mitral and Aortic Paravalvular Leak Repair: Indications, Current Application, and Future Directions. Curr Cardiol Rep 2013; 15:342. [DOI: 10.1007/s11886-012-0342-2] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
72
|
Multi-atlas segmentation with robust label transfer and label fusion. INFORMATION PROCESSING IN MEDICAL IMAGING : PROCEEDINGS OF THE ... CONFERENCE 2013; 23:548-59. [PMID: 24683998 DOI: 10.1007/978-3-642-38868-2_46] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Multi-atlas segmentation has been widely applied in medical image analysis. This technique relies on image registration to transfer segmentation labels from pre-labeled atlases to a novel target image and applies label fusion to reduce errors produced by registration-based label transfer. To improve the performance of registration-based label transfer against registration errors, our first contribution is to propose a label transfer scheme that generates multiple warped versions of each atlas to one target image through registration paths obtained by composing inter-atlas registrations and atlas-target registrations. The problem of decreasing quality of warped atlases caused by accumulative errors in composing multiple registrations is properly addressed by an atlas selection method that is guided by atlas segmentations. To improve the performance of label fusion against registration errors, our second contribution is to integrate the probabilistic correspondence model employed by the non-local mean approach with the joint label fusion technique, both of which have shown excellent performance for label fusion. Experiments on mitral-valve segmentation in 3D transesophageal echocardiography (TEE) show the effectiveness of the proposed techniques.
Collapse
|
73
|
Lee APW, Hsiung MC, Salgo IS, Fang F, Xie JM, Zhang YC, Lin QS, Looi JL, Wan S, Wong RHL, Underwood MJ, Sun JP, Yin WH, Wei J, Tsai SK, Yu CM. Quantitative analysis of mitral valve morphology in mitral valve prolapse with real-time 3-dimensional echocardiography: importance of annular saddle shape in the pathogenesis of mitral regurgitation. Circulation 2012; 127:832-41. [PMID: 23266859 DOI: 10.1161/circulationaha.112.118083] [Citation(s) in RCA: 141] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Few data exist on the relation of the 3-dimensional morphology of mitral valve and degree of mitral regurgitation (MR) in mitral valve prolapse. METHODS AND RESULTS Real-time 3-dimensional transesophageal echocardiography of the mitral valve was acquired in 112 subjects, including 36 patients with mitral valve prolapse and significant MR (≥3+; MR+ group), 32 patients with mitral valve prolapse but no or mild MR (≤2+; MR- group), 12 patients with significant MR resulting from nonprolapse pathologies (nonprolapse group), and 32 control subjects. The 3-dimensional geometry of mitral valve apparatus was measured with dedicated quantification software. Compared with the normal and MR- groups, the MR+ group had more dilated mitral annulus (P<0.0001), a reduced annular height to commissural width ratio (AHCWR) (P<0.0001) indicating flattening of annular saddle shape, redundant leaflet surfaces (P<0.0001), greater leaflet billow volume (P<0.0001) and billow height (P<0.0001), longer lengths from papillary muscles to coaptation (P<0.0001), and more frequent chordal rupture (P<0.0001). Prevalence of chordal rupture increased progressively with annulus flattening (7% versus 24% versus 42% for AHCWR >20%, 15%-20%, and <15%, respectively; P=0.004). Leaflet billow volume increased exponentially with decreasing AHCWR in patients without chordal rupture (r(2)=0.66, P<0.0001). MR severity correlated strongly with leaflet billow volume (r(2)=0.74, P<0.0001) and inversely with AHCWR (r(2)=0.44, P<0.0001). In contrast, annulus dilatation but not flattening occurred in nonprolapse MR patients. An AHCWR <15% (odds ratio=7.1; P=0.0004) was strongly associated with significant MR in mitral valve prolapse. CONCLUSION Flattening of the annular saddle shape is associated with progressive leaflet billowing and increased frequencies of chordal rupture and may be important in the pathogenesis of MR in mitral valve prolapse.
Collapse
Affiliation(s)
- Alex Pui-Wai Lee
- Li Ka Shing Institute of Health Sciences, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong SAR
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
74
|
Sohmer B, Hudson C, Atherstone J, Lambert AS, Labrosse M, Boodhwani M. Measuring aortic valve coaptation surface area using three-dimensional transesophageal echocardiography. Can J Anaesth 2012; 60:24-31. [DOI: 10.1007/s12630-012-9819-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2012] [Accepted: 10/19/2012] [Indexed: 11/28/2022] Open
|
75
|
van Neer PLMJ, Blaak S, Bosch JG, Lancée CT, Prins C, van der Steen AFW, de Jong N. Mode vibrations of a matrix transducer for three-dimensional second harmonic transesophageal echocardiography. ULTRASOUND IN MEDICINE & BIOLOGY 2012; 38:1820-1832. [PMID: 22958515 DOI: 10.1016/j.ultrasmedbio.2012.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2011] [Revised: 05/30/2012] [Accepted: 06/18/2012] [Indexed: 06/01/2023]
Abstract
Transesophageal echocardiography (TEE) uses the esophagus as an imaging window to the heart. This enables cardiac imaging without interference from the ribs or lungs and allows for higher frequency ultrasound to be used compared with transthoracic echocardiography (TTE). TEE facilitates the successful imaging of obese or elderly patients, where TTE may be unable to produce images of satisfactory quality. Recently, three-dimensional (3-D) TEE has been introduced, which greatly improves the image quality and diagnostic value of TEE by adding an extra dimension. Further improvement could be achieved by optimizing 3-D TEE for harmonic imaging. This article describes the optimal geometry and element configuration for a matrix probe for 3-D second harmonic TEE. The array concept features separated transmit and receive subarrays. The element geometry was studied using finite element modeling and a transmit subarray prototype was examined both acoustically and with laser interferometry. The transmit subarray is suitable for its role, with a 3 MHz resonance frequency, a 40%-50% -3 dB bandwidth and crosstalk levels <-27 dB. The proposed concept for the receive subarray has a 5.6 MHz center frequency and a 50% -3 dB bandwidth.
Collapse
Affiliation(s)
- Paul L M J van Neer
- Department of Biomedical Engineering, Erasmus Medical Centre, Rotterdam, The Netherlands
| | | | | | | | | | | | | |
Collapse
|
76
|
Mahmood F, Hess PE, Matyal R, Mackensen GB, Wang A, Qazi A, Panzica PJ, Lerner AB, Maslow A. Echocardiographic Anatomy of the Mitral Valve: A Critical Appraisal of 2-Dimensional Imaging Protocols With a 3-Dimensional Perspective. J Cardiothorac Vasc Anesth 2012; 26:777-84. [DOI: 10.1053/j.jvca.2012.06.017] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2011] [Indexed: 11/11/2022]
|
77
|
Hamada S, Altiok E, Frick M, Almalla M, Becker M, Marx N, Hoffmann R. Comparison of accuracy of mitral valve regurgitation volume determined by three-dimensional transesophageal echocardiography versus cardiac magnetic resonance imaging. Am J Cardiol 2012; 110:1015-20. [PMID: 22727180 DOI: 10.1016/j.amjcard.2012.05.037] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2012] [Revised: 05/23/2012] [Accepted: 05/23/2012] [Indexed: 11/18/2022]
Abstract
Direct planimetry of anatomic regurgitation orifice area (AROA) using 3-dimensional transesophageal echocardiography (TEE) has been described. This study sought to (1) compare mitral valve regurgitant volume (RV) derived by AROA using 3-dimensional TEE with RV obtained by cardiac magnetic resonance (CMR) imaging and (2) determine the impact of AROA and flow velocity changes throughout systole on the dynamic variation in mitral regurgitation. In 43 patients (71 ± 11 years old) with mild to severe mitral regurgitation, 3-dimensional TEE and CMR were performed. Mitral valve RV was determined based on (1) AROA at 5 subintervals of systole and analysis of the regurgitant continuous-wave Doppler signal at equal durations of systole, (2) effective regurgitation orifice area (EROA) using the proximal isovelocity surface area method, (3) CMR with subtraction of aortic outflow volume from left ventricular stroke volume. RV calculated by AROA tended to overestimate RV less than RV calculated by EROA compared to RV by CMR (average bias +20 ml, 95% confidence interval [CI] -41 to +81, vs +13 ml, 95% CI -22 to 47). In patients with RV >30 ml by CMR, overestimation of RV using the AROA method was less than using the EROA method (difference in means +18 ml, 95% CI 4 to 32, p <0.001). AROA determined by 3-dimensional TEE varied by only 18% among the 5 subintervals of systole, and the velocity time integral of the subinterval with the highest flow was 120% of the subinterval with the lowest flow. In conclusion, 3-dimensional TEE allows accurate analysis of mitral valve RV. In the clinically relevant group of patients with RV >30 ml as defined by CMR, the AROA method results in less overestimation of RV than the EROA method. Changes in AROA during systole contribute much less to dynamic variation in mitral regurgitation severity than changes in regurgitant flow velocity.
Collapse
Affiliation(s)
- Sandra Hamada
- Department of Cardiology, University Hospital RWTH Aachen, Aachen, Germany
| | | | | | | | | | | | | |
Collapse
|
78
|
|
79
|
Abstract
PURPOSE OF REVIEW To review the utility and the latest developments in three-dimensional (3D) echocardiography of mitral valve prolapse. RECENT FINDINGS Although 3D echocardiography was invented in 1974, it did not gain wide clinical acceptance until the introduction of real-time 3D echocardiography in the first decade of the 21st century. Driven by improvements in probe technology and increases in computing power, 3D echocardiography now provides unprecedented images of mitral valve prolapse and its associated mitral regurgitation with no or minimal requirements for image post processing. SUMMARY 3D echocardiography has become the echocardiographic modality of choice for establishing the diagnosis, describing the precise anatomy, and visualization of mitral regurgitant jets in mitral valve prolapse. 3D echocardiography is becoming indispensable in guiding surgical and percutaneous methods of mitral valve repair and replacement.
Collapse
|
80
|
Yu Z, Blaak S, Chang ZY, Yao J, Bosch JG, Prins C, Lancée CT, de Jong N, Pertijs MAP, Meijer GCM. Front-end receiver electronics for a matrix transducer for 3-D transesophageal echocardiography. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2012; 59:1500-1512. [PMID: 22828845 DOI: 10.1109/tuffc.2012.2350] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
There is a clear clinical need for creating 3-D images of the heart. One promising technique is the use of transesophageal echocardiography (TEE). To enable 3-D TEE, we are developing a miniature ultrasound probe containing a matrix piezoelectric transducer with more than 2000 elements. Because a gastroscopic tube cannot accommodate the cables needed to connect all transducer elements directly to an imaging system, a major challenge is to locally reduce the number of channels, while maintaining a sufficient signal-to-noise ratio. This can be achieved by using front-end receiver electronics bonded to the transducers to provide appropriate signal conditioning in the tip of the probe. This paper presents the design of such electronics, realizing time-gain compensation (TGC) and micro-beamforming using simple, low-power circuits. Prototypes of TGC amplifiers and micro-beamforming cells have been fabricated in 0.35-μm CMOS technology. These prototype chips have been combined on a printed circuit board (PCB) to form an ultrasound-receiver system capable of reading and combining the signals of three transducer elements. Experimental results show that this design is a suitable candidate for 3-D TEE.
Collapse
Affiliation(s)
- Zili Yu
- Electronic Instrumentation Lab, Delft University of Technology, Delft, The Netherlands.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
81
|
Ahlgren B, Dorosz J, Rohrer A, Reece B, Cleveland J, Salcedo E, Seres T. Real time three-dimensional transesophageal echocardiography in the evaluation of two cases of rare mitral valve tumors. Echocardiography 2012; 29:1011-5. [PMID: 22640169 DOI: 10.1111/j.1540-8175.2012.01716.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Bryan Ahlgren
- Department of Anesthesiology, University of Colorado Hospital, Aurora, Colorado, USA.
| | | | | | | | | | | | | |
Collapse
|
82
|
Influence of Chronic Tethering of the Mitral Valve on Mitral Leaflet Size and Coaptation in Functional Mitral Regurgitation. JACC Cardiovasc Imaging 2012; 5:337-45. [DOI: 10.1016/j.jcmg.2011.10.004] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2011] [Revised: 09/28/2011] [Accepted: 10/11/2011] [Indexed: 11/18/2022]
|
83
|
|
84
|
Kumar V, Nanda NC. Is It Time to Move on from Two-Dimensional Transesophageal to Three-Dimensional Transthoracic Echocardiography for Assessment of Left Atrial Appendage? Review of Existing Literature. Echocardiography 2012. [DOI: 10.1111/j.1540-8175.2011.01535.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
|
85
|
Sudhakar S, Khairnar P, Nanda NC. Live/Real Time Three-Dimensional Transesophageal Echocardiography. Echocardiography 2012. [DOI: 10.1111/j.1540-8175.2011.01525.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
|
86
|
Faletra FF, Regoli F, Acena M, Auricchio A. Value of Real-Time Transesophageal 3-Dimensional Echocardiography in Guiding Ablation of Isthmus-Dependent Atrial Flutter and Pulmonary Vein Isolation. Circ J 2012; 76:5-14. [DOI: 10.1253/circj.cj-11-1040] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
| | | | - Marta Acena
- Division of Cardiology, Fondazione Cardiocentro Ticino
| | | |
Collapse
|
87
|
Kliger C, Ruiz CE. Percutaneous Treatment of Primary and Secondary Mitral Regurgitation: Overall Scope of the Problem. Interv Cardiol Clin 2012; 1:73-83. [PMID: 28582069 DOI: 10.1016/j.iccl.2011.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Mitral regurgitation is a heterogeneous disorder requiring the understanding of complex mitral anatomy and pathophysiology. Advanced imaging has furthered our knowledge and ability to treat patients with this disorder. As the demand for less invasive treatment increases, a multitude of percutaneous options have emerged. This review is written for interventionalists to fully appreciate the overall scope of the problem of mitral regurgitation. Understanding and integrating mitral anatomy with pathophysiology, multimodality imaging, and current transcatheter mitral therapies are paramount for treating this disorder.
Collapse
Affiliation(s)
- Chad Kliger
- Lenox Hill Heart and Vascular Institute, Department of Cardiovascular Disease, Division of Structural and Congenital Heart Disease, 130 East 77th Street, 9th Floor Black Hall Building, New York, NY 10075, USA
| | - Carlos E Ruiz
- Lenox Hill Heart and Vascular Institute, Department of Cardiovascular Disease, Division of Structural and Congenital Heart Disease, 130 East 77th Street, 9th Floor Black Hall Building, New York, NY 10075, USA.
| |
Collapse
|
88
|
Hyodo E, Iwata S, Tugcu A, Oe Y, Koczo A, Shimada K, Muro T, Yoshikawa J, Yoshiyama M, Gillam LD, Hahn RT, Di Tullio MR, Homma S. Accurate measurement of mitral annular area by using single and biplane linear measurements: comparison of conventional methods with the three-dimensional planimetric method. Eur Heart J Cardiovasc Imaging 2011; 13:605-11. [DOI: 10.1093/ejechocard/jer300] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
89
|
Agricola E, Badano L, Mele D, Galderisi M, Slavich M, Sciomer S, Nistri S, Ballo P, D'Andrea A, Mondillo S. Real-time three dimensional transesophageal echocardiography: technical aspects and clinical applications. Heart Int 2011; 5:e6. [PMID: 21977291 PMCID: PMC3184702 DOI: 10.4081/hi.2010.e6] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2010] [Accepted: 04/06/2010] [Indexed: 11/22/2022] Open
Abstract
Real-time three-dimensional transesophageal echocardiography (RT3DTEE) is now commonly used in daily clinical practice. The transesophageal, compared to the transthoracic approach, allows the visualization of the whole spectrum of the mitral valve apparatus and the posterior cardiac structures. Moreover, images obtained by RT 3D TEE provide a unique and complete visualization of the mitral valve prosthetic elements. Indeed, the possibility to visualize guidewires and catheters in cardiac chambers and their relationship with cardiac structures during percutaneous transcatheter procedures reduces the time of radiation exposure and simplifies the approach becoming the reference method for monitoring. This review aims to underline the potential clinical applications and the advantages of RT3DTEE compared to other methods.
Collapse
Affiliation(s)
- Eustachio Agricola
- Division of Non-Invasive Cardiology, Cardiothoracic Department, San Raffaele Hospital, Milano, Italy
| | | | | | | | | | | | | | | | | | | |
Collapse
|
90
|
Le Gloan L, Mercier LA, Dore A, Marcotte F, Ibrahim R, Mongeon FP, Asgar A, Miro J, Poirier N, Khairy P. Recent advances in adult congenital heart disease. Circ J 2011; 75:2287-95. [PMID: 21881245 DOI: 10.1253/circj.cj-11-0601] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
As a result of major achievements in pediatric cardiac care, a growing number of patients with congenital heart disease (CHD) are flourishing well into adulthood. This heterogeneous and aging population of patients, many of whom represent the first generation of middle-age survivors, faces unique issues and challenges. As a field, adult CHD has evolved markedly during the past decade on several fronts, including imaging, arrhythmia management, percutaneous interventions, surgical techniques, research, and multidisciplinary care that extends beyond the cardiac realm. This review highlights recent advances across the wide spectrum of key issues encountered by adults with CHD.
Collapse
Affiliation(s)
- Laurianne Le Gloan
- Adult Congenital Heart Center, Montreal Heart Institute, Université de Montréal, Montréal, Canada
| | | | | | | | | | | | | | | | | | | |
Collapse
|
91
|
Real-time three-dimensional echocardiography during percutaneous edge-to-edge mitral valve repair. J Cardiovasc Echogr 2011. [DOI: 10.1016/j.jcecho.2011.05.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
|
92
|
Chen X, Sun D, Yang J, Feng W, Gu T, Zhang Z, Xiu Z, Tang L, Ma C, Wang X, Cheng Y, Li N, Liu S. Preoperative Assessment of Mitral Valve Prolapse and Chordae Rupture Using Real Time Three-Dimensional Transesophageal Echocardiography. Echocardiography 2011; 28:1003-10. [DOI: 10.1111/j.1540-8175.2011.01474.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
|
93
|
Fusini L, Tamborini G, Gripari P, Maffessanti F, Mazzanti V, Muratori M, Salvi L, Sisillo E, Caiani EG, Alamanni F, Fiorentini C, Pepi M. Feasibility of Intraoperative Three-Dimensional Transesophageal Echocardiography in the Evaluation of Right Ventricular Volumes and Function in Patients Undergoing Cardiac Surgery. J Am Soc Echocardiogr 2011; 24:868-77. [DOI: 10.1016/j.echo.2011.05.002] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2011] [Indexed: 10/18/2022]
|
94
|
Chahal M, Pandya U, Adlakha S, Khouri SJ. Live 3D TEE Demonstrates and Guides the Management of Prosthetic Mitral Valve Obstruction. Echocardiography 2011; 28:E146-8. [DOI: 10.1111/j.1540-8175.2011.01412.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
|
95
|
Schlosshan D, Aggarwal G, Mathur G, Allan R, Cranney G. Real-Time 3D Transesophageal Echocardiography for the Evaluation of Rheumatic Mitral Stenosis. JACC Cardiovasc Imaging 2011; 4:580-8. [DOI: 10.1016/j.jcmg.2010.12.009] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2010] [Revised: 11/08/2010] [Accepted: 12/02/2010] [Indexed: 11/29/2022]
|
96
|
Faletra FF, Nucifora G, Ho SY. Imaging the Atrial Septum Using Real-Time Three-Dimensional Transesophageal Echocardiography: Technical Tips, Normal Anatomy, and Its Role in Transseptal Puncture. J Am Soc Echocardiogr 2011; 24:593-9. [DOI: 10.1016/j.echo.2011.01.022] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2010] [Indexed: 01/29/2023]
|
97
|
Furukawa K, Kamohara K, Itoh M, Furutachi A, Mukae Y, Morita S. Real-Time Three-Dimensional Transesophageal Echocardiography Is Useful for the Localization of a Small Mitral Paravalvular Leak. Ann Thorac Surg 2011; 91:e72-3. [DOI: 10.1016/j.athoracsur.2011.01.033] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2010] [Revised: 11/21/2010] [Accepted: 01/10/2011] [Indexed: 10/18/2022]
|
98
|
Anatomy of right atrial structures by real-time 3D transesophageal echocardiography. JACC Cardiovasc Imaging 2011; 3:966-75. [PMID: 20846634 DOI: 10.1016/j.jcmg.2010.03.014] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2010] [Revised: 03/18/2010] [Accepted: 03/23/2010] [Indexed: 12/31/2022]
Abstract
The rapid development of catheter ablation techniques for atrial arrhythmias has triggered a renewed interest in the anatomy of the right atrium. In particular, some atrial arrhythmias such as focal atrial arrhythmias or atrial flutter have been linked to the anatomic architecture of specific structures such as the crista terminalis or cavotricuspid isthmus. Real-time 3-dimensional transesophageal echocardiography (RT 3D TEE) is a recently developed technique that provides 3D images of unprecedented quality. Because the right atrium is very close to the transducer, this technique may provide high-quality images of those atrial structures involved in ablation procedures. This review describes a step-by-step approach for acquisition and processing of RT 3D TEE images of right atrial structures of relevance to electrophysiologists. For anatomical correlations of RT 3D TEE images, selected images of right atrial structures were matched to anatomical specimens.
Collapse
|
99
|
Szili-Torok T, Bosch JG. Transnasal transoesophageal ultrasound: the end of the intracardiac echocardiography age? Europace 2011; 13:7-8. [PMID: 21149509 DOI: 10.1093/europace/euq438] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
100
|
Tauras JM, Zhang Z, Taub CC. Incremental benefit of 3D transesophageal echocardiography: a case of a mass overlying a prosthetic mitral valve. Echocardiography 2011; 28:E106-7. [PMID: 21426395 DOI: 10.1111/j.1540-8175.2011.01383.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
A young woman with a mechanical mitral valve and prosthetic mitral stenosis underwent multiple imaging modalities (including transthoracic ECHO, fluoroscopy, and two-dimensional transesophageal ECHO) to determine the cause of her stenosis. Only three-dimensional transesophageal echocardiography demonstrated the full size and extent of an obstructing mass on the strut and sewing ring of the prosthetic mitral valve.
Collapse
Affiliation(s)
- James M Tauras
- Montefiore-Einstein Heart Center, Weiler Hospital, Bronx, New York 10461, USA.
| | | | | |
Collapse
|