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Pillai MN, Suneel PR, Menon S, Unnikrishnan KP, Baruah SD, Mathew T, Lovhale SP, Dharan BS. Intraoperative Three-dimensional Imaging of Ventricular Septal Defects in Children Using Epicardial Echocardiography: A Novel Approach. J Cardiothorac Vasc Anesth 2021; 35:2892-2899. [DOI: 10.1053/j.jvca.2020.10.051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 10/23/2020] [Accepted: 10/25/2020] [Indexed: 11/11/2022]
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Zaidi SJ, Penk J, Schweig L, Cui VW, Cossor W, Roberson DA. Added Value of Live 3-Dimensional Transesophageal Echocardiography During Procedures in Fontan Patients. Pediatr Cardiol 2020; 41:1370-1375. [PMID: 32488509 DOI: 10.1007/s00246-020-02388-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 05/27/2020] [Indexed: 11/26/2022]
Abstract
3D transesophageal echocardiography (3D-TEE) has proven useful and accurate during some operating room (OR), interventional cardiac catheterization (Cath), and electrophysiologic (EP) procedures. The use of 3D-TEE during similar procedures in patients who have undergone Fontan surgery and its additional value have not been previously reported. To determine if live 3D-TEE during procedures post Fontan has added value, 3D-TEEs in 58 post-Fontan patients over a 5-year study period were reviewed. Additional information provided by 3D-TEE (over 2D-TEE) was classified into the following: A: new information which changed/refined the plan and 0: no new important information. Pre- and post-bypass OR 3D-TEEs were counted as one study. A total of 67 3D-TEEs (41 Cath, 13 OR, and 13 EP procedures) were performed. Median age was 14 years (6-39 years). Median weight was 47 kg (21-109 kg). In Cath procedures, only 2/41 (5%) were graded A (R to L atrial level shunt [Fontan leak], n = 1; thrombus in pulmonary artery stump, n = 1). In the OR, 6/13 (46%) were graded A (atrioventricular valvuloplasty, n = 1; neo-aortic valvuloplasty, n = 1; relief of systemic and pulmonary venous outflow obstruction, n = 2 and n = 2; respectively). In EP procedures, 4/13 (31%) were graded A (thrombus, n = 3; mapping for lead placement to assist in multisite pacing for dyssynchrony, n = 1). 3D-TEE of Fontan improved visualization and frequently added value in the OR/EP lab and may be helpful in select catheterization cases. Future studies with a larger sample could build on this data to identify when 3D-TEE will be most useful.
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Affiliation(s)
- S Javed Zaidi
- Department of Pediatric Cardiology, Advocate Children's Hospital, Chicago, IL, USA.
- Department of Pediatric Cardiology, Advocate BroMenn Medical Center, Normal, IL, 61761, USA.
| | - Jamie Penk
- Department of Pediatric Cardiology, Advocate Children's Hospital, Chicago, IL, USA
| | - Lorene Schweig
- Department of Pediatric Cardiology, Advocate Children's Hospital, Chicago, IL, USA
| | - Vivian W Cui
- Department of Pediatric Cardiology, Advocate Children's Hospital, Chicago, IL, USA
| | - Waseem Cossor
- Department of Pediatric Cardiology, Advocate Children's Hospital, Chicago, IL, USA
| | - David A Roberson
- Department of Pediatric Cardiology, Advocate Children's Hospital, Chicago, IL, USA
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Transthoracic closure of ventricular septal defects guided by transesophageal echocardiography. TURK GOGUS KALP DAMAR CERRAHISI DERGISI-TURKISH JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY 2020; 28:250-256. [PMID: 32551154 DOI: 10.5606/tgkdc.dergisi.2020.18745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 02/07/2019] [Indexed: 11/21/2022]
Abstract
Background This study aims to investigate the effectiveness and safety of transthoracic closure of ventricular septal defects totally guided by transesophageal echocardiography. Methods A total of 119 patients (62 males, 57 females; mean age 2.1±5.2 years; range, 11 months to 50 years) who underwent transthoracic closure of ventricular septal defects in our center between April 2017 and November 2018 were included. All patients were evaluated in terms of the diameter and morphological features of ventricular septal defects via transesophageal echocardiography. During the procedure, transthoracic echocardiography was used as the only guiding tool for occluder implantation. Results Of the patients, 116 underwent successful transthoracic device closure procedure. Two patients were switched to surgical repair due to new-onset aortic regurgitation in one patient and severe arrhythmias after device release in the other patient. One patient underwent a second operation for occluder migration during the hospital stay. In the first attempt, 106 ventricular septal defect occluders were correctly positioned. Transthoracic echocardiography revealed the insecure position or significant residual shunting in 10 patients. The original device was replaced with an asymmetric device or a more extensive occluder, and satisfactory results were finally obtained. No complications such as new-onset aortic regurgitation, residual shunt, complete heart block, or device dislodgement occurred during follow-up. Conclusion Transthoracic closure of ventricular septal defects under the total guidance of transthoracic echocardiography is a safe and effective method.
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Li M, Li L, Wu W, Ran H, Zhang P. Left ventricular dyssynchrony in coronary artery disease patients without regional wall-motion abnormality: Correlation with Gensini score. Echocardiography 2019; 36:1689-1697. [PMID: 31403750 DOI: 10.1111/echo.14453] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 06/16/2019] [Accepted: 07/18/2019] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES Our study investigated left ventricular dyssynchrony (LVD) in coronary artery disease (CAD) patients without regional wall-motion abnormality (RWMA) by three-dimensional echocardiography (3-DE) and explored the relationship between LVD and severity of CAD as assessed by the Gensini score (GS). METHODS Sixty-one patients with a confirmed diagnosis of CAD by coronary angiography (CAG) were enrolled. We quantified LVD parameters, including the left ventricular segments (16, 12, and 6) standard deviation of the time to minimum systolic volume (TmsvSD-16, TmsvSD-12, and TmsvSD-6) and the systolic dyssynchrony index in regions 16, 12, and 6 (16R-SDI, 12R-SDI, 6R-SDI) using 3-DE. The severity of coronary atherosclerotic lesions was evaluated by the GS system on the basis of CAG findings. We further divided all patients into three groups according to the tertiles of GS: low-GS ≤20, mid-GS >20 and ≤48, and high-GS >48. The differences of LVD values among the three groups were compared, and the associations between LVD parameters and GS were analyzed. RESULTS Coronary artery disease patients demonstrated increased LVD parameters compared with healthy controls. TmsvSD12, 16R-SDI, and 6R-SDI were prolonged in the high-GS group compared with the low- and mid-GS groups. 16R-SDI was positively correlated with the GS, and multivariate regression analysis showed that 16R-SDI was an independent predictor of the GS. 16R-SDI above 10.7% had a sensitivity of 84.21% and a specificity of 92.86% for identifying high-GS. CONCLUSION Three-dimensional echocardiography is a noninvasive technique to detect LVD in non-RWMA CAD patients, and the parameter 16R-SDI was significantly correlated with CAD severity.
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Affiliation(s)
- Miao Li
- Department of Cardiovascular Ultrasound, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Lin Li
- Department of Cardiovascular Ultrasound, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Wenfang Wu
- Department of Cardiovascular Ultrasound, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Hong Ran
- Department of Cardiovascular Ultrasound, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Pingyang Zhang
- Department of Cardiovascular Ultrasound, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
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Yang HS. Three-dimensional echocardiography in adult congenital heart disease. Korean J Intern Med 2017; 32:577-588. [PMID: 28704916 PMCID: PMC5511944 DOI: 10.3904/kjim.2016.251] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2016] [Accepted: 06/16/2017] [Indexed: 12/27/2022] Open
Abstract
Congenital heart disease (CHD) is now more common in adults than in children due to improvements in fetal echo, neonatal and pediatric care, and surgical techniques leading to dramatically increased survivability into adulthood. Adult patients with CHD, regardless of prior cardiac surgery, experience further cardiac problems or therapeutic challenges; therefore, a non-invasive, easily accessible echocardiographic examination is an essential follow-up tool. Among echocardiographic modalities, three-dimensional (3D) echocardiography provides better delineation of spatial relationships in complex cardiac geometries and more accurate volumetric information without geometric assumptions. For atrial septal defects, an en face view of the tissue defect allows better decisions on device closure. For tricuspid valve malformations, an en face view provides diagnostic information that is difficult to obtain from routine 2D tomography. In repaired tetralogy of fallot with pulmonary regurgitation, preoperative 3D echocardiography- based right ventricular volume may be used to determine the timing of a pulmonary valve replacement in conjunction with cardiovascular magnetic imaging. For optimal adult CHD care, 3D echocardiography is an important complement to routine 2D echocardiography.
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Affiliation(s)
- Hyun Suk Yang
- Correspondence to Hyun Suk Yang, M.D. Division of Cardiovascular Medicine, Department of Internal Medicine, Konkuk University Medical Center, 120-1 Neungdong-ro, Gwangjin-gu, Seoul 05030, Korea Tel: +82-2-2030-7519 Fax: +82-2-2030-7748 E-mail:
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Velasco O, Beckett MQ, James AW, Loehr MN, Lewis TG, Hassan T, Janardhanan R. Real-Time Three-Dimensional Echocardiography: Characterization of Cardiac Anatomy and Function-Current Clinical Applications and Literature Review Update. Biores Open Access 2017; 6:15-18. [PMID: 28303211 PMCID: PMC5349224 DOI: 10.1089/biores.2016.0033] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Our review of real-time three-dimensional echocardiography (RT3DE) discusses the diagnostic utility of RT3DE and provides a comparison with two-dimensional echocardiography (2DE) in clinical cardiology. A Pubmed literature search on RT3DE was performed using the following key words: transthoracic, two-dimensional, three-dimensional, real-time, and left ventricular (LV) function. Articles included perspective clinical studies and meta-analyses in the English language, and focused on the role of RT3DE in human subjects. Application of RT3DE includes analysis of the pericardium, right ventricular (RV) and LV cavities, wall motion, valvular disease, great vessels, congenital anomalies, and traumatic injury, such as myocardial contusion. RT3DE, through a transthoracic echocardiography (TTE), allows for increasingly accurate volume and valve motion assessment, estimated LV ejection fraction, and volume measurements. Chamber motion and LV mass approximation have been more accurately evaluated by RT3DE by improved inclusion of the third dimension and quantification of volumetric movement. Moreover, RT3DE was shown to have no statistical significance when comparing the ejection fractions of RT3DE to cardiac magnetic resonance (CMR). Analysis of RT3DE data sets of the LV endocardial exterior allows for the volume to be directly quantified for specific phases of the cardiac cycle, ranging from end systole to end diastole, eliminating error from wall motion abnormalities and asymmetrical left ventricles. RT3DE through TTE measures cardiac function with superior diagnostic accuracy in predicting LV mass, systolic function, along with LV and RV volume when compared with 2DE with comparable results to CMR.
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Affiliation(s)
- Omar Velasco
- Department of Internal Medicine, University of Arizona , Tucson, Arizona
| | - Morgan Q Beckett
- Department of Chemistry and Biochemistry, University of Arizona , Tucson, Arizona
| | - Aaron W James
- Department of Pathology, Johns Hopkins University , Baltimore, Maryland
| | - Megan N Loehr
- Department of Chemistry and Biochemistry, University of Arizona , Tucson, Arizona
| | - Taylor G Lewis
- Department of Chemistry and Biochemistry, University of Arizona , Tucson, Arizona
| | - Tahmin Hassan
- Department of Chemistry and Biochemistry, University of Arizona , Tucson, Arizona
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Simpson J, Lopez L, Acar P, Friedberg MK, Khoo NS, Ko HH, Marek J, Marx G, McGhie JS, Meijboom F, Roberson D, Van den Bosch A, Miller O, Shirali G. Three-dimensional Echocardiography in Congenital Heart Disease: An Expert Consensus Document from the European Association of Cardiovascular Imaging and the American Society of Echocardiography. J Am Soc Echocardiogr 2016; 30:1-27. [PMID: 27838227 DOI: 10.1016/j.echo.2016.08.022] [Citation(s) in RCA: 71] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Three-dimensional echocardiography (3DE) has become important in the management of patients with congenital heart disease (CHD), particularly with pre-surgical planning, guidance of catheter intervention, and functional assessment of the heart. 3DE is increasingly used in children because of good acoustic windows and the non-invasive nature of the technique. The aim of this paper is to provide a review of the optimal application of 3DE in CHD including technical considerations, image orientation, application to different lesions, procedural guidance, and functional assessment.
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Affiliation(s)
- John Simpson
- Evelina London Children's Hospital, London, United Kingdom.
| | - Leo Lopez
- Nicklaus Children's Hospital, Miami, Florida
| | | | | | - Nee S Khoo
- Stollery Children's Hospital & University of Alberta, Edmonton, Alberta, Canada
| | - H Helen Ko
- Mt. Sinai Medical Center, New York, New York
| | - Jan Marek
- Great Ormond Street Hospital for Children, London, United Kingdom
| | - Gerald Marx
- Boston Children's Hospital and Harvard School of Medicine, Boston, Massachusetts
| | - Jackie S McGhie
- Erasmus University Medical Center, Rotterdam, The Netherlands
| | | | - David Roberson
- Advocate Children's Hospital, Chicago Medical School, Chicago, Illinois
| | | | - Owen Miller
- Evelina London Children's Hospital, London, United Kingdom
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Simpson J, Lopez L, Acar P, Friedberg M, Khoo N, Ko H, Marek J, Marx G, McGhie J, Meijboom F, Roberson D, Van den Bosch A, Miller O, Shirali G. Three-dimensional echocardiography in congenital heart disease: an expert consensus document from the European Association of Cardiovascular Imaging and the American Society of Echocardiography. Eur Heart J Cardiovasc Imaging 2016; 17:1071-97. [DOI: 10.1093/ehjci/jew172] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Accepted: 06/28/2016] [Indexed: 01/02/2023] Open
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Hadeed K, Hascoet S, Amadieu R, Karsenty C, Cuttone F, Leobon B, Dulac Y, Acar P. Assessment of Ventricular Septal Defect Size and Morphology by Three-Dimensional Transthoracic Echocardiography. J Am Soc Echocardiogr 2016; 29:777-785. [DOI: 10.1016/j.echo.2016.04.012] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Indexed: 12/01/2022]
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Wunderlich NC, Küx H, Kreidel F, Birkemeyer R, Siegel RJ. The Changing Paradigm in the Treatment of Structural Heart Disease and the Need for the Interventional Imaging Specialist. Interv Cardiol 2016; 11:135-139. [PMID: 29588721 DOI: 10.15420/icr.2016:12:2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Percutaneous interventions in structural heart diseases are emerging rapidly. The variety of novel percutaneous treatment approaches and the increasing complexity of interventional procedures are associated with new challenges and demands on the imaging specialist. Standard catheterisation laboratory imaging modalities such as fluoroscopy and contrast ventriculography provide inadequate visualisation of the soft tissue or three-dimensional delineation of the heart. Consequently, additional advanced imaging technology is needed to diagnose and precisely identify structural heart diseases, to properly select patients for specific interventions and to support fluoroscopy in guiding procedures. As imaging expertise constitutes a key factor in the decision-making process and in the management of patients with structural heart disease, the sub-speciality of interventional imaging will likely develop out of an increased need for high-quality imaging.
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Affiliation(s)
| | - Harald Küx
- Cardiovascular Center Darmstadt, Darmstadt, Germany
| | - Felix Kreidel
- Department of Cardiology, Asklepios Klinik, St Georg Hospital, Hamburg, Germany
| | | | - Robert J Siegel
- The Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
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11
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Cossor W, Cui VW, Roberson DA. Three-Dimensional Echocardiographic En Face Views of Ventricular Septal Defects: Feasibility, Accuracy, Imaging Protocols and Reference Image Collection. J Am Soc Echocardiogr 2015; 28:1020-9. [PMID: 26141981 DOI: 10.1016/j.echo.2015.05.014] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Indexed: 10/23/2022]
Abstract
BACKGROUND Ventricular septal defect (VSD) is the most common congenital cardiac anomaly. Accurate assessment is critical for planning treatment. Recent advances in three-dimensional (3D) echocardiography have improved image quality and ease of use. METHODS The feasibility and accuracy of three specific 3D echocardiographic protocols to demonstrate en face views of VSDs were analyzed in a retrospective review of 100 consecutive patients. Sixty-four patients underwent transthoracic echocardiography and 36 transesophageal echocardiography. Types of VSDs included 34 muscular, 32 perimembranous, 18 malaligned, 11 inlet, four outlet, and one acquired. Ages ranged from 1 day to 77 years, and body weights from 3 to 92 kg. Three-dimensional echocardiographic full-volume mode with standard XYZ and adjustable plane cropping, 3D full-volume mode with iCrop, and narrow-sector live 3D protocols were compared for feasibility and accuracy to obtain a diagnostic-quality en face view of a VSD. RESULTS The success rate for obtaining a high-quality en face image for the three protocols was 100% for full-volume mode with iCrop, 97% for full-volume standard mode, and 94% for narrow-sector live 3D mode. The ability of both full-volume mode with iCrop and full-volume standard mode to demonstrate a VSD was slightly better than that of narrow-sector live 3D mode (P < .001 for both vs narrow-sector live 3D mode). In all patients, the type, size, and location of the VSD were demonstrated accurately by two or more of the protocols. CONCLUSIONS Three-dimensional echocardiography of VSDs is feasible and accurate in most patients using defined protocols. The protocols are described and illustrated in detail, and a reference 3D image collection is presented.
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Affiliation(s)
- Waseem Cossor
- Advocate Children's Hospital Heart Institute, Chicago Medical School, Oak Lawn, Illinois
| | - Vivian Wei Cui
- Advocate Children's Hospital Heart Institute, Chicago Medical School, Oak Lawn, Illinois
| | - David A Roberson
- Advocate Children's Hospital Heart Institute, Chicago Medical School, Oak Lawn, Illinois.
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Liu Y, Frikha Z, Maureira P, Levy B, Selton-Suty C, Villemot JP, Huttin O. 3D transesophageal echocardiography is a decision-making tool for the management of cardiogenic shock following a large postinfarction ventricular defect. J Cardiothorac Surg 2015; 10:8. [PMID: 25603876 PMCID: PMC4312472 DOI: 10.1186/s13019-015-0208-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2014] [Accepted: 01/07/2015] [Indexed: 11/13/2022] Open
Abstract
Postinfarction ventricular septal defect (PIVSD) is a devastating mechanical complication following acute myocardial infarction. The management of this pathology is quite challenging, especially in case of complicated cardiogenic shock. The difficulties lie in the timing and type of intervention. Debates exist with regard to immediate versus deferring repair, as well as open repair versus percutaneous closure. The anatomic characteristics and hemodynamic consequence of PIVSD are important elements determining which strategy to adopt, since large septal defect (>15 mm) cannot be appropriately treated by percutaneous occluder devices limiting by their available size, while compromised hemodynamics usually require emergent repair or mechanical support “bridging to surgery”. Herein, we report our experience of successful management of a case of cardiogenic shock complicating large PIVSD (38 mm) by delayed surgical repair bridged with Extracorporeal Membrane Oxygenation (ECMO) during 7 days. We emphasize the importance of 3-dimensional transesophageal echocardiography as a decision-making tool.
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Affiliation(s)
- Yihua Liu
- Department of cardiovascular surgery and heart transplantation, 1, Allée du Morvan, F-54500, Vandoeuvre-lès-Nancy, France.
| | - Zied Frikha
- Department of cardiology, CHU-Nancy, F-54000, France.
| | - Pablo Maureira
- Department of cardiovascular surgery and heart transplantation, 1, Allée du Morvan, F-54500, Vandoeuvre-lès-Nancy, France.
| | - Bruno Levy
- Department of critical care medicine, CHU-Nancy, F-54000, France.
| | | | - Jean-pierre Villemot
- Department of cardiovascular surgery and heart transplantation, 1, Allée du Morvan, F-54500, Vandoeuvre-lès-Nancy, France.
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Charakida M, Pushparajah K, Anderson D, Simpson JM. Insights Gained From Three-Dimensional Imaging Modalities for Closure of Ventricular Septal Defects. Circ Cardiovasc Imaging 2014; 7:954-61. [DOI: 10.1161/circimaging.114.002502] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Marietta Charakida
- From the Department of Congenital Heart Disease, Evelina London Children’s Hospital, London, United Kingdom
| | - Kuberan Pushparajah
- From the Department of Congenital Heart Disease, Evelina London Children’s Hospital, London, United Kingdom
| | - David Anderson
- From the Department of Congenital Heart Disease, Evelina London Children’s Hospital, London, United Kingdom
| | - John M. Simpson
- From the Department of Congenital Heart Disease, Evelina London Children’s Hospital, London, United Kingdom
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Charakida M, Pushparajah K, Simpson J. 3D echocardiography in congenital heart disease: a valuable tool for the surgeon. Future Cardiol 2014; 10:497-509. [PMID: 25301313 DOI: 10.2217/fca.14.38] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Real-time 3D echocardiography has been used increasingly in the assessment of patients with congenital heart disease. A number of studies have confirmed that this modality can be used as a complementary method to delineate morphology and spatial relationships of simple and more complex congenital heart lesions during surgical planning. Communication between the echocardiographer and surgeon can be simplified as simulation of surgical views can be achieved, thus minimizing the potential for error related to mental reconstruction. This review summarizes the available evidence for the role of real-time 3D echocardiography in congenital heart disease as an imaging modality to assist surgeons.
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Affiliation(s)
- Marietta Charakida
- Department of Congenital Heart Disease, Evelina London Children's Hospital, London, SE1 7EH, UK
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Carminati M, Agnifili M, Arcidiacono C, Brambilla N, Bussadori C, Butera G, Chessa M, Heles M, Micheletti A, Negura DG, Piazza L, Saracino A, Testa L, Tusa M, Bedogni F. Role of imaging in interventions on structural heart disease. Expert Rev Cardiovasc Ther 2014; 11:1659-76. [DOI: 10.1586/14779072.2013.854166] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Akgun T, Karabay CY, Kocabay G, Oduncu V, Kalayci A, Guler A, Ozveren O, Yilmaz F, Akcakoyun M, Kirma C. Discrepancies between Doppler and catheter gradients in ventricular septal defect: a correction of localized gradients from pressure recovery phenomenon. Int J Cardiovasc Imaging 2013; 30:39-45. [DOI: 10.1007/s10554-013-0291-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2013] [Accepted: 09/05/2013] [Indexed: 10/26/2022]
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Abstract
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.
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Affiliation(s)
- Girish S Shirali
- Department of Pediatrics, Pediatric Cardiology, Medical University of South Carolina, Charleston, South Carolina 29425, USA.
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18
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Evaluation of Atrial and Ventricular Septal Defects with Real-Time Three-Dimensional Echocardiography: Current Status and Literature Review. CURRENT CARDIOVASCULAR IMAGING REPORTS 2011. [DOI: 10.1007/s12410-011-9102-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Kamra K, Russell I, Miller-Hance WC. Role of transesophageal echocardiography in the management of pediatric patients with congenital heart disease. Paediatr Anaesth 2011; 21:479-93. [PMID: 21481076 DOI: 10.1111/j.1460-9592.2011.03570.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Transesophageal echocardiography (TEE) has become a critical diagnostic and perioperative management tool for patients with congenital heart disease (CHD) undergoing cardiac and noncardiac surgical procedures. This review highlights the role of TEE in routine management of pediatric cardiac patient population with focus on indications, views, applications and technological advances.
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Affiliation(s)
- Komal Kamra
- Department of Anesthesiology, Stanford University, Lucile Packard Children’s Hospital, Palo Alto, CA, USA.
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Simpson JM, Miller O. Three-dimensional echocardiography in congenital heart disease. Arch Cardiovasc Dis 2011; 104:45-56. [DOI: 10.1016/j.acvd.2010.11.004] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2010] [Revised: 11/15/2010] [Accepted: 11/16/2010] [Indexed: 01/17/2023]
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Zhu D, Tao KY, Liu B. Successful Repair of a Traumatic Ventricular Septal Defect Using an Amplatzer Occluder Guided By Three-Dimensional Transesophageal Echocardiography. J Card Surg 2010; 25:685-9. [DOI: 10.1111/j.1540-8191.2010.01132.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Shah SJ, Bardo DME, Sugeng L, Weinert L, Lodato JA, Knight BP, Lopez JJ, Lang RM. Real-time three-dimensional transesophageal echocardiography of the left atrial appendage: initial experience in the clinical setting. J Am Soc Echocardiogr 2009; 21:1362-8. [PMID: 19041579 DOI: 10.1016/j.echo.2008.09.024] [Citation(s) in RCA: 86] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2008] [Indexed: 11/15/2022]
Abstract
BACKGROUND The aim of this study was to determine the feasibility and accuracy of a new real-time 3-dimensional (RT3D) matrix-array transesophageal echocardiographic probe for the determination of left atrial appendage (LAA) geometry. METHODS Sixty-six consecutive patients (mean age, 53 +/- 17 years) referred for 2-dimensional (2D) transesophageal echocardiography (TEE) underwent additional RT3D TEE. The feasibility of RT3D TEE for LAA geometry was studied in the first 37 patients, and 2D and RT3D transesophageal echocardiographic quantification of the LAA were compared in the subsequent 29 patients. The LAA orifice diameter and depth were measured using biplane 2D TEE, and LAA orifice area was calculated as an ellipse. LAA orifice area and depth were measured in 3D and correlated to 2D measurement and were also correlated to 64-slice cardiac computed tomography (CT) in 8 patients. RESULTS All 66 patients underwent RT3D matrix-array TEE without complication. In the feasibility study, the LAA was well visualized in 95%. In the quantitation study, 2D TEE underestimated LAA orifice area compared with 3D imaging (3.1 +/- 1.3 vs 4.2 +/- 2.2 cm(2); r = 0.55). LAA depth by 2D and 3D imaging were well correlated (3.7 +/- 0.7 vs 3.4 +/- 0.7 cm; r = 0.77). LAA orifice area on CT was well correlated with area on 3D TEE (r = 0.98) but not with area 2D TEE (r = 0.13). Bland-Altman analysis demonstrated that 2D TEE systematically underestimated LAA orifice area compared with 3D TEE (mean bias, -1.0 cm(2), with wide limits of agreement [-4.6 to 2.6 cm(2)]). In the 8 patients who underwent both 3D TEE and CT, the mean bias was 0.15 cm(2), with narrow limits of agreement (-0.50 to 0.20 cm(2)). CONCLUSIONS RT3D TEE for the visualization and quantitative analysis of LAA orifice area is feasible and correlates well with 64-slice cardiac CT.
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Affiliation(s)
- Sanjiv J Shah
- Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois 60611, USA.
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Hudson PA, Eng MH, Kim MS, Quaife RA, Salcedo EE, Carroll JD. A comparison of echocardiographic modalities to guide structural heart disease interventions. J Interv Cardiol 2008; 21:535-46. [PMID: 18973503 DOI: 10.1111/j.1540-8183.2008.00410.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Percutaneous techniques to treat structural heart disease are rapidly evolving based on innovative interventions and the considerable advancement in image guidance technology. While two-dimensional transthoracic and transesophageal echocardiography have been integral to procedural planning and execution, intracardiac and three-dimensional echocardiography supply unique visualization of target structures with a potential improvement in patient safety and procedural efficacy. The choice of image guidance modality is based on specific differences between imaging systems, as well as other variables including cost, patient safety, operator expertise, and complexity of procedure. We will compare the adjunctive imaging tools for structural heart disease interventions, with a focus on intracardiac echocardiography and real-time three-dimensional transesophageal echocardiography.
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Affiliation(s)
- Paul A Hudson
- Division of Cardiology, University of Colorado Denver, Aurora, Colorado 80045, USA
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Affiliation(s)
- Karim A Diab
- Heart and Lung Institute, Scott and Laura Eller Congenital Heart Center, St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA
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Abstract
Matrix array technology has brought three-dimensional echocardiography into the clinical practice of cardiology. Arguably, this advancement is most notable in the field of pediatric cardiology. Full-volume acquisitions now can be undertaken in the youngest of infants with excellent image quality. This article illustrates the clinical application of three-dimensional echocardiography in congenital heart disease.
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Affiliation(s)
- Gerald R Marx
- Department of Cardiology, Children's Hospital Boston, Farley-2, 300 Longwood Avenue, Boston, MA 02115, USA.
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