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Sordelli C, Weisz SH, Fele N, Verde R, Guarino A, Perrella A, Severino L, Severino C, Severino S. Three-dimensional Transesophageal Echocardiography in Infective Endocarditis: What Does It Add? J Cardiovasc Echogr 2024; 34:1-6. [PMID: 38818319 PMCID: PMC11135816 DOI: 10.4103/jcecho.jcecho_80_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 02/23/2024] [Accepted: 02/29/2024] [Indexed: 06/01/2024] Open
Abstract
Infective endocarditis (IE) diagnosis is based on a clinical suspicion supported by consistent microbiological and instrumental data. Evidence of involvement of cardiac valves (native or prosthetic) or prosthetic intracardiac material is a major diagnostic criterion of IE. Transthoracic echocardiography (TTE) is the initial technique of choice for the diagnosis while transesophageal echocardiography (TEE) is recommended in patients with an inconclusive or negative TTE, in patients with high suspicion of IE, as well as in patients with a positive TTE, in order to document local complications. Repeating TTE and/or TEE should be considered during follow-up of uncomplicated IE, in order to detect new silent complications and monitor vegetation size. In the setting of IE, the role of three-dimensional (3D) TEE is increasing; in fact, this technique has also been shown to be useful for the diagnosis of IE and its complications as it allows to obtain infinite planes and volumetric reconstructions. In this review, we will describe the usefulness of 3D-TEE and its added value in the management of IE.
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Affiliation(s)
- Chiara Sordelli
- Infectious Cardiology Disease Unit, Ospedale Cotugno, Naples, Italy
| | - Sara Hana Weisz
- Infectious Cardiology Disease Unit, Ospedale Cotugno, Naples, Italy
| | - Nunzia Fele
- Infectious Cardiology Disease Unit, Ospedale Cotugno, Naples, Italy
| | - Raffaele Verde
- Infectious Cardiology Disease Unit, Ospedale Cotugno, Naples, Italy
| | - Angela Guarino
- Infectious Cardiology Disease Unit, Ospedale Cotugno, Naples, Italy
| | | | - Laura Severino
- Infectious Cardiology Disease Unit, Ospedale Cotugno, Naples, Italy
| | - Corrado Severino
- Infectious Cardiology Disease Unit, Ospedale Cotugno, Naples, Italy
| | - Sergio Severino
- Infectious Cardiology Disease Unit, Ospedale Cotugno, Naples, Italy
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Three-Dimensional Transesophageal Echocardiography in the Diagnosis and Treatment of Mitral Prosthetic Valve Endocarditis—A Narrative Review. Medicina (B Aires) 2021; 58:medicina58010023. [PMID: 35056331 PMCID: PMC8779064 DOI: 10.3390/medicina58010023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 12/19/2021] [Accepted: 12/22/2021] [Indexed: 01/10/2023] Open
Abstract
Despite advances in diagnosis, imaging methods, and medical and surgical interventions, prosthetic valve endocarditis (PVE) remains an extremely serious and potentially fatal complication of heart valve surgery. Characteristic changes of PVE are more difficult to detect by transthoracic echocardiography (TTE) than those involving the native valve. We reviewed advances in transesophageal echocardiography (TEE) in the diagnosis of PVE. Three-dimensional (3D) TEE is becoming an increasingly available imaging method combined with two-dimensional TEE. It contributes to faster and more accurate diagnosis of PVE, assessment of PVE-related complications, monitoring effectiveness of antibiotic treatment, and determining optimal time for surgery, sometimes even before or without previous TTE. In this article, we present advances in the treatment of patients with mitral PVE due to 3D TEE application.
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Baltodano-Arellano R, Cupe-Chacalcaje K, Cachicatari-Beltrán Á. [Stuck valve leaflet detected by 3D transesophageal echocardiography]. ARCHIVOS PERUANOS DE CARDIOLOGIA Y CIRUGIA CARDIOVASCULAR 2021; 2:216-218. [PMID: 37727522 PMCID: PMC10506567 DOI: 10.47487/apcyccv.v2i3.144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 07/22/2021] [Indexed: 09/21/2023]
Affiliation(s)
- Roberto Baltodano-Arellano
- Hospital Nacional Guillermo Almenara Irigoyen, EsSalud. Lima-Perú. Hospital Nacional Guillermo Almenara Irigoyen, EsSalud Lima Perú
- Facultad de Medicina, Universidad Nacional Mayor de San Marcos. Lima-Perú. Universidad Nacional Mayor de San Marcos Facultad de Medicina Universidad Nacional Mayor de San Marcos Lima Peru
| | - Kelly Cupe-Chacalcaje
- Hospital Nacional Guillermo Almenara Irigoyen, EsSalud. Lima-Perú. Hospital Nacional Guillermo Almenara Irigoyen, EsSalud Lima Perú
| | - Ángela Cachicatari-Beltrán
- Hospital Nacional Guillermo Almenara Irigoyen, EsSalud. Lima-Perú. Hospital Nacional Guillermo Almenara Irigoyen, EsSalud Lima Perú
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Kalçık M, Özkan M, Gündüz S, Gürsoy MO, Yesin M, Bayam E, Güner A, Kalkan S, Karakoyun S, Tanboğa Hİ. Normal reference values for mechanical mitral prosthetic valve inner diameters and areas assessed by two-dimensional and real-time three-dimensional transesophageal echocardiography. Int J Cardiovasc Imaging 2020; 37:547-557. [PMID: 33011903 DOI: 10.1007/s10554-020-02039-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Accepted: 09/18/2020] [Indexed: 11/30/2022]
Abstract
It was previously observed that two dimensional (2D) Doppler derived and real-time three-dimensional (RT-3D) directly measured valve areas were smaller than reported manufacturer sizes. It may be helpful to obtain the ranges of inner diameters (IDs) and the geometric orifice area (GOA) during evaluation of prosthetic mitral valves. In this study, we aimed to provide reference dimensional parameters of bileflet mitral mechanical prosthetic valves. Patients with recent mitral valve replacement were examined by 2D and RT-3D transesophageal echocardiography (TEE) in the early postoperative period when the presence of pannus overgrowth was unlikely. Measurements of 2D IDs, 3D hinge to hinge (HHD) and edge to edge diameters (EED) and 3D GOA were obtained and compared with reported manufacturer sizes and areas. This study enrolled 126 patients with mitral prosthetic valves (38 ATS, 42 Carbomedics, 46 St. Jude Medical, all bileaflet). The measured 2D and 3D IDs and GOA were significantly smaller than reported manufacturer sizes in the majority of the valve sizes. This RT-3D TEE-guided study provides ranges of reference values for directly measured IDs and GOA of the three most commonly used mechanical mitral prosthetic valve types for the first time in a relatively large series.
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Affiliation(s)
- Macit Kalçık
- Faculty of Medicine, Department of Cardiology, Hitit University, Buharaevler Mah. Buhara 25. Sok. No:1 /A Daire:22, Çorum, Turkey.
| | - Mehmet Özkan
- Department of Cardiology, Koşuyolu Kartal Heart Training and Research Hospital, Istanbul, Turkey.,Division of Health Sciences, Ardahan University, Ardahan, Turkey
| | - Sabahattin Gündüz
- Department of Cardiology, Koşuyolu Kartal Heart Training and Research Hospital, Istanbul, Turkey
| | - Mustafa Ozan Gürsoy
- Department of Cardiology, Izmir Katip Çelebi University, Atatürk Training and Research Hospital, Izmir, Turkey
| | - Mahmut Yesin
- Faculty of Medicine, Department of Cardiology, Kars Kafkas University, Kars, Turkey
| | - Emrah Bayam
- Department of Cardiology, Koşuyolu Kartal Heart Training and Research Hospital, Istanbul, Turkey
| | - Ahmet Güner
- Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
| | - Semih Kalkan
- Department of Cardiology, Koşuyolu Kartal Heart Training and Research Hospital, Istanbul, Turkey
| | - Süleyman Karakoyun
- Faculty of Medicine, Department of Cardiology, Kars Kafkas University, Kars, Turkey
| | - Halil İbrahim Tanboğa
- Faculty of Medicine, Department of Cardiology, Nisantasi University, Istanbul, Turkey
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Kim JY, Suh YJ, Han K, Kim YJ, Choi BW. Diagnostic Value of Advanced Imaging Modalities for the Detection and Differentiation of Prosthetic Valve Obstruction. JACC Cardiovasc Imaging 2019; 12:2182-2192. [DOI: 10.1016/j.jcmg.2018.11.033] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 11/19/2018] [Accepted: 11/28/2018] [Indexed: 01/18/2023]
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Babu S, Koniparambil UP, Kumar M, Radhakrishnan BK, Aggarwal N, Nanda S. Distortion of aortic valve from mechanical traction imposed by the mitral valve prosthesis: The three-dimensional transesophageal echocardiographic perception. Ann Card Anaesth 2017; 20:472-474. [PMID: 28994691 PMCID: PMC5661325 DOI: 10.4103/aca.aca_176_16] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Iatrogenic injury to the aortic valve is a rare but frequently reported complication during mitral valve surgeries. Intraoperative 2-dimensional transesophageal echocardiography (2D TEE) has a major impact in diagnosing these injuries, so that timely intervention is possible. However, 2D TEE has lot of limitations during the perioperative period, which can be overcome by the three dimensional echocardiography (3D-TEE). We report a case where 3D TEE has undoubtedly delineated the cause for distortion of aortic sinus after mitral valve replacement and helped in the successful outcome.
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Affiliation(s)
- Saravana Babu
- Department of Cardiothoracic and Vascular Anaesthesia, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India
| | - Unnikrishnan P Koniparambil
- Department of Cardiothoracic and Vascular Anaesthesia, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India
| | - Muthu Kumar
- Department of Cardiothoracic and Vascular Anaesthesia, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India
| | - Bineesh K Radhakrishnan
- Department of Cardiothoracic and Vascular Surgery, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India
| | - Neelam Aggarwal
- Department of Cardiothoracic and Vascular Anaesthesia, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India
| | - Saurabh Nanda
- Department of Cardiothoracic and Vascular Surgery, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India
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Maslow A, Szymanski T, Mahmood F. Three-Dimensional Echocardiographic Assessment of a Paravalvular Leak. J Cardiothorac Vasc Anesth 2016; 31:1308-1311. [PMID: 27939193 DOI: 10.1053/j.jvca.2016.09.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Indexed: 11/11/2022]
Affiliation(s)
- Andrew Maslow
- Department of Anesthesiology, Rhode Island Hospital, Needham, MA.
| | - Trevor Szymanski
- Department of Anesthesiology, Rhode Island Hospital, Needham, MA
| | - Feroze Mahmood
- Department of Anesthesiology, Beth Israel Deaconess Medical Center, Boston, MA
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Cruz-Gonzalez I, Rama-Merchan JC, Arribas-Jimenez A, Rodriguez-Collado J, Martin-Moreiras J, Cascon-Bueno M, Luengo CM. Cierre percutáneo de fugas periprotésicas con el dispositivo Amplatzer Vascular Plug III: resultados inmediatos y a corto plazo. Rev Esp Cardiol 2014. [DOI: 10.1016/j.recesp.2013.09.033] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Cruz-Gonzalez I, Rama-Merchan JC, Arribas-Jimenez A, Rodriguez-Collado J, Martin-Moreiras J, Cascon-Bueno M, Luengo CM. Paravalvular leak closure with the Amplatzer Vascular Plug III device: immediate and short-term results. ACTA ACUST UNITED AC 2014; 67:608-14. [PMID: 25037539 DOI: 10.1016/j.rec.2013.09.031] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Accepted: 09/24/2013] [Indexed: 12/14/2022]
Abstract
INTRODUCTION AND OBJECTIVES Percutaneous paravalvular leak closure is a complex procedure with varying success rates; the lack of closure devices specifically designed for this purpose has hampered this technique. The characteristics of the Amplatzer Vascular Plug III appear to be well suited for paravalvular leak closures; however, the available data are limited to case reports or small series of patients. The aim of this study was to analyze the feasibility and efficacy of paravalvular leak with this device. METHODS The immediate and 90-day safety and efficacy of mitral and aortic paravalvular leak closures performed with this device at our hospital were analyzed. RESULTS Percutaneous repair of 34 paravalvular leaks (27 mitral, 7 aortic) was attempted in 33 patients. The device was successfully implanted in 93.9% (in 2 patients, a second planned procedure was needed), and successful closure (defined as regurgitation reduction ≥ 1 grade) was achieved in 90.9% of patients. Complications included emergency surgery due to disc interference (n=1) and blood transfusion (n=3). There were no reports of procedure-related death, myocardial infarction, or stroke. At 90 days, survival was 100%, and 90.3% of patients showed significant clinical improvement; 4 patients developed vascular complications (pseudoaneurysm). CONCLUSIONS Mitral and aortic paravalvular leak closure with the Amplatzer Vascular Plug III is feasible and safe, with high clinical and echocardiographic success rates.
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Affiliation(s)
| | | | | | | | | | - Manuel Cascon-Bueno
- Servicio de Cardiología, Hospital Universitario de Salamanca, Salamanca, Spain
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Tsang W, Lang RM. Three-dimensional echocardiography is essential for intraoperative assessment of mitral regurgitation. Circulation 2013; 128:643-52; discussion 652. [PMID: 23918185 DOI: 10.1161/circulationaha.112.120501] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Wendy Tsang
- Toronto General Hospital, University of Toronto, Toronto, ON, Canada
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12
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Scandura S, Cammalleri V, Caggegi A, Castello A, Ronsivalle G, Dipasqua F, Arcidiacono AA, Indelicato A, Mignosa C, Tamburino C. Three-dimensional echocardiographic and surgical findings in mitral mechanical valve dysfunction. J Cardiovasc Med (Hagerstown) 2012; 14:317-8. [PMID: 22801073 DOI: 10.2459/jcm.0b013e328356a3e0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Periodic echocardiographic evaluation of valve function is recommended in all patients with prosthetic valves. Usually trans-thoracic echocardiography (TTE) is satisfactory to assess prosthetic function. Nevertheless when the TTE is suboptimal or in case of strong clinical doubt of prosthetic valve dysfunction, trans-esophageal echocardiography (TEE) remains the gold standard of imaging. Recent advancements in echocardiography, with the three-dimensional (3D) reconstruction, provide an incremental diagnostic value as compared to two-dimensional TEE. In addition, 3D-TEE gives unique views that add extra morphological and anatomical information, providing a very accurate presurgical evaluation.
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Affiliation(s)
- Salvatore Scandura
- Division of Cardiology, Ferrarotto Hospital, University of Catania, Italy
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Rodríguez-Bailón I, Carrasco-Chinchilla F, Ruiz-Salas A, Melero-Tejedor JM, Sánchez-Espín G, Ruiz-Morales J, de Teresa-Galván E. Right atrium vegetation in prosthetic aortic endocarditis. Int J Cardiol 2012; 156:335-6. [DOI: 10.1016/j.ijcard.2012.02.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2012] [Revised: 01/30/2012] [Accepted: 02/05/2012] [Indexed: 10/28/2022]
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Albertí JFF, de Diego JJG, Delgado RV, Riera JC, Torres RA. [State of the art: new developments in cardiac imaging]. Rev Esp Cardiol 2012; 65 Suppl 1:24-34. [PMID: 22269837 DOI: 10.1016/j.recesp.2011.11.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2011] [Accepted: 11/03/2011] [Indexed: 11/16/2022]
Abstract
Cardiac imaging continues to reveal new anatomical and functional insights into heart disease. In echocardiography, both transesophageal and transthoracic three-dimensional imaging have been fully developed and optimized, and the value of the techniques that have increased our understanding of cardiac mechanics and ventricular function is well established. At the same time, the healthcare industry has released new devices onto the market which, although they are easier to use, have limitations that restrict their use for routine assessment. Tomography's diagnostic and prognostic value in coronary artery disease continues to increase while radiation exposure becomes progressively lower. With cardiac magnetic resonance imaging, myocardial injury and recovery in ischemic heart disease and following acute coronary syndrome can be monitored in exquisite detail. The emergence of new combined tomographic and gamma camera techniques, exclusively developed for nuclear cardiology, have improved the quality of investigations and reduced radiation exposure. The hybrid or fusion images produced by combining different techniques, such as nuclear cardiology techniques and tomography, promise an exciting future.
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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
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16
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Real time three-dimensional transesophageal echocardiography in the anatomical assessment of complex mitral valve regurgitation secondary to endocarditis. Rev Esp Cardiol 2011; 65:188-90. [PMID: 21813229 DOI: 10.1016/j.recesp.2011.04.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2011] [Accepted: 04/13/2011] [Indexed: 11/23/2022]
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