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Akdogan RE, Srialluri S, Abdelsalam MGA, Hsiung MC, Nanda NC, Fadala H, Yin WH. Incremental value of right parasternal transthoracic echocardiographic examination over the left parasternal approach in assessing ascending aorta size: Additional benefit of three-dimensional echocardiography. Echocardiography 2019; 36:1306-1314. [PMID: 31215702 DOI: 10.1111/echo.14412] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 05/28/2019] [Accepted: 05/28/2019] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND The ascending aorta (AA) has not been well studied using two-dimensional right parasternal transthoracic echocardiographic examination (2DRPE). AIM The aim of the present study was to assess the incremental value of 2DRPE over two-dimensional left parasternal transthoracic echocardiographic examination (2DLPE) in evaluating the size of AA in adult patients (pts) and, secondly, to determine whether live/real time three-dimensional (3D) RPE provided any additional benefit over 2DRPE. MATERIALS AND METHODS The AA was successfully imaged by 2DLPE, 2DRPE, and 3D RPE in 87 of 141 (61.7%) pts which comprised of two groups of consecutive pts separated by an interval of 2 weeks. RESULTS The maximum length of AA visualized by 2DRPE (4.98 ± 0.89) was larger than 2DLPE in 76/87(87%) pts (P < 0.001). Both the maximum systolic AA inner luminal width and leading edge-to-leading edge width by 2DRPE were greater than 2DLPE (P < 0.001). Similar to other noninvasive imaging modalities where mid-AA width is taken at level of right pulmonary artery, mid-AA width could also be taken at this level by 2DRPE in 79/87(91%) pts since this landmark was visualized during 2DRPE. However, this vessel could be visualized in only 2/87 (2%) pts with 2DLPE. 3DRPE conferred additional benefit over 2DRPE. The maximal AA length by 3DRPE was larger than 2DRPE in 60/87(69%) pts, and the maximal inner lumen and leading edge to leading edge widths were larger in 54/87(62%) and 66/87(76%) pts, respectively. CONCLUSION Our preliminary study demonstrates significant incremental value of 2DRPE over 2DLPE in the assessment of AA. 3DRPE confers an additional advantage over 2DRPE.
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Affiliation(s)
- Raziye E Akdogan
- Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, Alabama
| | - Swetha Srialluri
- Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, Alabama
| | - Mahmoud G A Abdelsalam
- Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, Alabama
| | - Ming C Hsiung
- Division of Cardiology, Cheng Hsin General Hospital, Taipei, Taiwan
| | - Navin C Nanda
- Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, Alabama
| | - Hanan Fadala
- Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, Alabama
| | - Wei-Hsian Yin
- Heart Center, Cheng Hsin General Hospital and Faculty of Medicine, School of Medicine, National Yang Ming University, Taipei, Taiwan
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Elsheikh RG, Darweish AZ, Elsetiha M, Kamel H. Comparative study between real time three dimensional echocardiogram and angiography in evaluation of patent ductus arteriosus, single center experience. J Saudi Heart Assoc 2014; 26:204-11. [PMID: 25278722 DOI: 10.1016/j.jsha.2014.02.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2013] [Revised: 01/21/2014] [Accepted: 02/13/2014] [Indexed: 11/30/2022] Open
Abstract
UNLABELLED In this study we compared the real time three dimensional echocardiogram data in evaluation of patent ductus arteriosus with the gold standard angiography. METHODS This study included 25 patients with PDA referred to Tanta University Hospital for elective cardiac catheterization. The patients comprised seven males and 18 females, with a mean age of 3.7 ± 0.36 years. The study duration was six months. All patients underwent full 2D echocardiogram as well as real time three-dimensional echocardiogram (RT3DE). Essential measurements included the pulmonary end of the duct, duct length, aortic end and aortic ampulla as well as the anatomical type of the PDA. Data obtained by RT3DE were compared against 2D echocardiogram and angiography. RESULTS There was no significant difference between 3D echocardiogram and angiography (P = 0.001) in the pulmonary end of the duct measurement. Neither were there any significant differences between the length of the duct or the aortic end measured by 3D echocardiogram and by angiography (P = 0.001 in both). While there was adequate agreement between both 2D and 3D echocardiogram and angiography in determining the anatomical type of the PDA, 3D echocardiogram determined type A and type E ductus more accurately than 2D echocardiogram. The feasibility of Q lab analysis of PDA was 96%, while the feasibility of gated color flow 3D acquisitions in determining anatomical types was 64%. CONCLUSION There was complete agreement on location, size, morphology and surrounding structure of PDA between 2D and 3D echocardiogram, and angiography. This result illustrates the need for the proper placement of the device in catheterization laboratories.
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Chugh R, Salem MM. Echocardiography for Patent Ductus Arteriosus Including Closure in Adults. Echocardiography 2014; 32 Suppl 2:S125-39. [DOI: 10.1111/echo.12457] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
- Reema Chugh
- Cardiology Division; CMOB 308; Kaiser Permanente Medical Center; Panorama City California
| | - Morris M. Salem
- Pediatric Cardiology; Kaiser Permanente-Los Angeles Medical Center; Los Angeles California
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Roushdy A, Fiky AE, Din DEE. Visualization of patent ductus arteriosus using real-time three-dimensional echocardiogram: Comparative study with 2D echocardiogram and angiography. J Saudi Heart Assoc 2012; 24:177-86. [PMID: 23960692 DOI: 10.1016/j.jsha.2012.02.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2011] [Revised: 01/27/2012] [Accepted: 02/04/2012] [Indexed: 11/29/2022] Open
Abstract
PURPOSE To determine the feasibility and accuracy of real time 3D echocardiography (RT3DE) in determining the dimensions and anatomical type of the patent ductus arteriosus (PDA). METHODS The study included 42 pediatric patients with a mean age of 3.6 years (ranging from 2 months to 14 years) who were referred for elective percutaneous PDA closure. All patients underwent full 2D echocardiogram as well as RT3DE with off line analysis using Q lab software within 6 h from their angiograms. The PDA was studied as regard the anatomical type, length of the duct as well as the ampulla and the pulmonary end of the PDA. Data obtained by RT3DE was compared against 2D echocardiogram and the gold standard angiography. RESULTS Offline analysis of the PDA was feasible in 97.6% of the cases while determination of the anatomical type using gated color flow 3D acquisitions was achieved in 78.5% of the cases. The pulmonary end of the duct was rather elliptical using 3D echocardiogram. There was significant difference between the pulmonary end measured by 3D echocardiogram and angiography (P < 0.001). There was no significant difference between either the length or the ampulla of the PDA measured by 3D echocardiogram and that measured by angiography (P value = 0.325 and 0.611, respectively). There was a good agreement between both 2D or 3D echocardiogram and angiography in determining the anatomical type of the PDA (K = 0.744 and 0.773, respectively). However 3D echocardiogram could more accurately determine type A and type E ductus compared to 2D echocardiogram. CONCLUSION 3D echocardiogram was more accurate than 2D echocardiogram in determining the length and the ampulla of the PDA. The morphologic assessment of the PDA using gated 3D color flow was achieved in 78.5% of the patients. Nevertheless the use of 3D echocardiogram in assessment of small vascular structures like PDA in children with rapid heart rates is still of limited clinical value.
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Affiliation(s)
- Alaa Roushdy
- Cardiology Department, Ain Shams University Hospital, Cairo
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Hage FG, Raslan S, Dean P, Nanda NC. Real Time Three-Dimensional Transthoracic Echocardiography in Congenital Heart Disease. Echocardiography 2011; 29:220-31. [DOI: 10.1111/j.1540-8175.2011.01555.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Khanna D, Vengala S, Miller AP, Nanda NC, Lloyd SG, Ahmed S, Sinha A, Mehmood F, Bodiwala K, Upendram S, Gownder M, Dod HS, Nunez A, Pacifico AD, McGiffin DC, Kirklin JK, Misra VK. Quantification of Mitral Regurgitation by Live Three-Dimensional Transthoracic Echocardiographic Measurements of Vena Contracta Area. Echocardiography 2009; 21:737-43. [PMID: 15546375 DOI: 10.1111/j.0742-2822.2004.40027.x] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
We evaluated 44 consecutive patients who underwent standard two-dimensional (2D) and live three-dimensional (3D) transthoracic echocardiography (TTE), as well as left heart catheterization with left ventriculography. Mitral regurgitant vena contracta area (VCA) was obtained by 3D TTE by systematic and sequential cropping of the acquired 3D TTE data set. Assessment of mitral regurgitation (MR) by ventriculography was compared to measurements of VCA by 3D TTE and to 2D TTE measurements of MR jet area to left atrial area (RJA/LAA), RJA alone, vena contracta width (VCW), and calculated VCA. VCA from 3D TTE closely correlated with angiographic grading (rs=0.88) with very little overlap. VCA of <0.2 cm2 correlated with mild MR, 0.2-0.4 cm2 with moderate MR, and >0.4 cm2 with severe MR by angiography. Ventriculographic grading also correlated well with 2D TTE measurements of RJA/LAA (rs=0.79) and RJA alone (rs=0.76) but with more overlap. Assessment of VCW and calculated VCA by 2D TTE agreed least with ventriculography (rs=0.51 and rs=0.55, respectively). Live 3D TTE color Doppler measurements of VCA can be used for quantitative assessment of MR and is comparable to assessment by ventriculography.
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Affiliation(s)
- Deepak Khanna
- Division of Cardiovascular Diseases, The University of Alabama at Birmingham, Birmingham, Alabama 35249, USA
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Sinha A, Nanda NC, Panwar RB, Kasliwal RR, Chauhan N, Beniwal S, Panwar SR, Khanna D, Bodiwala K, Mehmood F, Upendram S, Vengala S. Live Three-Dimensional Transthoracic Echocardiographic Assessment of Left Ventricular Hydatid Cyst. Echocardiography 2009; 21:699-705. [PMID: 15546370 DOI: 10.1111/j.0742-2822.2004.04005.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
We report an adult patient in whom live three-dimensional transthoracic echocardiography (3DTTE) complemented two-dimensional transthoracic echocardiography (2DTTE) in making a definitive diagnosis of a hydatid cyst located in the left ventricular cavity. The parent hydatid cyst, as well as the daughter cysts, contained within it could be delineated by both 2DTTE and live 3DTTE. However, the tertiary or granddaughter cysts originating from the daughter cysts as well as great-granddaughter cysts budding from tertiary cysts could be visualized only when the live 3DTTE data sets were cropped and sectioned sequentially using multiple cutting planes. In addition, apparent intrinsic mobility of some of the tertiary cysts implying viability was detected only by 3DTTE.
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Affiliation(s)
- Ashish Sinha
- University of Alabama at Birmingham, Division of Cardiovascular Disease, Birmingham, Alabama 35249, USA
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Pothineni KR, Wells BJ, Hsiung MC, Nanda NC, Yelamanchili P, Suwanjutah T, Prasad AR, Hansalia S, Lin CC, Yin WH, Young MS. Live/Real Time Three-Dimensional Transthoracic Echocardiographic Assessment of Pulmonary Regurgitation. Echocardiography 2008; 25:911-7. [DOI: 10.1111/j.1540-8175.2008.00721.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Pothineni KR, Nanda NC, Burri MV, Bell WC, Post JD. Live/Real Time Three-Dimensional Transthoracic Echocardiographic Description of Chordoma Metastatic to the Heart. Echocardiography 2008; 25:440-2. [DOI: 10.1111/j.1540-8175.2008.00639.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Pothineni KR, Nanda NC, Burri MV, Singh A, Panwar SR, Gandhari S. Live/Real Time Three-Dimensional Transthoracic Echocardiographic Visualization of Chiari Network. Echocardiography 2007; 24:995-7. [PMID: 17894581 DOI: 10.1111/j.1540-8175.2007.00503.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
We report the usefulness of live/real time three-dimensional transthoracic echocardiography in the visualization of Chiari network.
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Affiliation(s)
- Koteswara R Pothineni
- Division of Cardiovascular Diseases, University of Alabama at Birmingham, 619 19th Street South, Birmingham, AL 35249, USA
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Pothineni KR, Duncan K, Yelamanchili P, Nanda NC, Patel V, Fan P, Burri MV, Singh A, Panwar SR. Live/Real Time Three-Dimensional Transthoracic Echocardiographic Assessment of Tricuspid Valve Pathology: Incremental Value over the Two-Dimensional Technique. Echocardiography 2007; 24:541-52. [PMID: 17456074 DOI: 10.1111/j.1540-8175.2007.00451.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Twenty-nine patients with different tricuspid valve (TV) pathologies were studied by both two-dimensional transthoracic (2DTTE) and live/real time three-dimensional transthoracic echocardiography (3DTTE). A major contribution of 3DTTE over 2DTTE was the en face visualization of all three leaflets of the TV in all patients. This allowed accurate assessment of TV orifice area in patients with TV stenosis and carcinoid disease. Loss of TV leaflet tissue, defects in TV leaflets and size of TV systolic non-coaptation could also be delineated and resulted in identifying the mechanism of tricuspid regurgitation (TR) in patients with Ebstein's anomaly and rheumatic heart disease. Prolapse of TV leaflets could also be well visualized and enabled us to develop a schema for systematic assessment of individual segment prolapse which could help in surgical planning. The exact sites of chordae rupture in patients with flail TV as well as right ventricular papillary muscle rupture could be well seen by 3DTTE. 3DTTE also permitted sectioning of various TV masses for more specific diagnosis of their nature. In addition, color Doppler 3DTTE provided an estimate of quantitative evaluation of TR severity, since the exact shape and size of the vena contracta could be accurately assessed. In conclusion, our preliminary experience with 3DTTE has demonstrated substantial incremental value over 2DTTE in the assessment of various TV pathologies.
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Affiliation(s)
- Koteswara R Pothineni
- Division of Cardiovascular Diseases, University of Alabama at Birmingham, Birmingham, Alabama 35249, USA
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Upendram S, Nanda NC, Mehmood F, Vengala S, Dod HS, Bodiwala KN, Reddy VVB, McGiffin DC. Live Three‐Dimensional Transthoracic Echocardiographic Assessment of Right Atrial Thrombus. ACTA ACUST UNITED AC 2007; 13:330-1. [PMID: 15538073 DOI: 10.1111/j.1076-7460.2004.02729.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Sailendra Upendram
- Division of Cardiovascular Disease, University of Alabama at Birmigham 35249, USA
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Mehta D, Nanda NC, Vengala S, Mehmood F, Taylor J. Live Three‐Dimensional Transthoracic Echocardiographic Demonstration of Coronary Artery to Pulmonary Artery Fistula. ACTA ACUST UNITED AC 2007; 14:42-4. [PMID: 15654155 DOI: 10.1111/j.1076-7460.2005.04191.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Affiliation(s)
- Deval Mehta
- Division of Cardiovascular Diseases, University of Alabama at Birmingham, Heart Station SW/S102, 619 19th Street, Birmingham, AL 35249, USA
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Patel V, Nanda NC, Arellano I, Yelamanchili P, Rajdev S, Baysan O. Cor Triatriatum Sinister: Assessment by Live/Real Time Three-Dimensional Transthoracic Echocardiography. Echocardiography 2006; 23:801-2. [PMID: 16999703 DOI: 10.1111/j.1540-8175.2006.00315.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
We report a 49-year-old morbidly obese female with a poor acoustic window in whom live/real time three-dimensional transthoracic echocardiography was able to make a confident diagnosis of cor triatriatum sinister. En face views of the membrane facilitated accurate assessment of the size and shape of the large nonobstructing opening in the membrane. Maximum dimensions of the opening were 3.06 x 1.03 cm and area was 2.3 cm(2).
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Affiliation(s)
- Vinod Patel
- Division of Cardiovascular Diseases, The University of Alabama at Birmingham, Heart Station SWB-S102, 619 South 19th Street, Birmingham, AL 35249, USA
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Velayudhan DE, Brown TM, Nanda NC, Patel V, Miller AP, Mehmood F, Rajdev S, Fang L, Frans EE, Vengala S, Madadi P, Yelamanchili P, Baysan O. Quantification of Tricuspid Regurgitation by Live Three-Dimensional Transthoracic Echocardiographic Measurements of Vena Contracta Area. Echocardiography 2006; 23:793-800. [PMID: 16999702 DOI: 10.1111/j.1540-8175.2006.00314.x] [Citation(s) in RCA: 81] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
We evaluated tricuspid regurgitation (TR) by multiple echocardiographic techniques in 93 consecutive patients who underwent standard two-dimensional (2D) and live three-dimensional (3D) transthoracic echocardiography (TTE). TR vena contracta (VC) area was obtained by 3D TTE by systematic and sequential cropping of the acquired 3D TTE dataset. Assessment of VC area by 3D TTE was compared to 2D TTE measurements of the ratio of TR regurgitant jet area to right atrial area (RJA/RAA), RJA alone, VC width, and calculated VC area. VC area from 3D TTE closely correlated with RJA/RAA and RJA alone as determined from 2D TTE measurements. Live 3D TTE color Doppler measurements of VC area can be used for quantitative assessment of TR and offer incremental value for quantification of particularly severe regurgitant lesions.
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Affiliation(s)
- Dasan E Velayudhan
- Division of Cardiovascular Diseases, The University of Alabama at Birmingham, Heart Station SW-S102, 619 South 19th Street, Birmingham, AL 35249, USA
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Hlavacek A, Lucas J, Baker H, Chessa K, Shirali G. Feasibility and Utility of Three-Dimensional Color Flow Echocardiography of the Aortic Arch: The “Echocardiographic Angiogram”. Echocardiography 2006; 23:860-4. [PMID: 17069605 DOI: 10.1111/j.1540-8175.2006.00328.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Two-dimensional transthoracic echocardiography (2DE) is the most commonly used diagnostic modality to evaluate congenital and acquired abnormalities of the aortic arch. However, 2DE is frequently limited in this ability due to the three-dimensional character of the arch and its interrelationships with other vascular structures. Recently, three-dimensional echocardiography (3DE) with 3D color flow Doppler became commercially available. We examined the feasibility and utility of 3DE with 3D color Doppler in the evaluation of patients with congenital (native and postoperative) abnormalities of the aortic arch. We found that 3DE color flow provides important diagnostic information in patients with aortic arch anomalies, in a manner that is quick and user-friendly. In addition, 17 of the 26 patients had their 3DE findings confirmed by additional modalities, providing reasonably significant validation for our findings with 3DE.
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MESH Headings
- Adolescent
- Adult
- Aorta, Thoracic/abnormalities
- Aorta, Thoracic/diagnostic imaging
- Aortic Coarctation/diagnostic imaging
- Aortic Diseases/congenital
- Aortic Diseases/diagnostic imaging
- Aortic Stenosis, Supravalvular/congenital
- Aortic Stenosis, Supravalvular/diagnostic imaging
- Child
- Child, Preschool
- Ductus Arteriosus, Patent/diagnostic imaging
- Echocardiography, Doppler, Color/methods
- Echocardiography, Three-Dimensional/methods
- Feasibility Studies
- Female
- Humans
- Hypoplastic Left Heart Syndrome/diagnostic imaging
- Infant
- Infant, Newborn
- Male
- Middle Aged
- Reproducibility of Results
- Research Design
- Retrospective Studies
- Transposition of Great Vessels/diagnostic imaging
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Affiliation(s)
- Anthony Hlavacek
- Department of Pediatric Cardiology, Medical University of South Carolina, Charleston, South Carolina 29425, USA.
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Patel V, Hsiung MC, Nanda NC, Miller AP, Fang L, Yelamanchili P, Mehmood F, Gupta M, Duncan K, Singh A, Rajdev S, Fan P, Naftel DC, McGiffin DC, Pacifico AD, Kirklin JK, Lin CC, Yin WH, Young MS, Chang CY, Wei J. Usefulness of Live/Real Time Three-Dimensional Transthoracic Echocardiography in the Identification of Individual Segment/Scallop Prolapse of the Mitral Valve. Echocardiography 2006; 23:513-8. [PMID: 16839393 DOI: 10.1111/j.1540-8175.2006.00252.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
In this report, we present 34 patients in whom surgical intervention was undertaken for severe mitral insufficiency due to mitral valve prolapse (MVP). Location and severity of MVP and regurgitation were assessed preoperatively by live/real time three-dimensional transthoracic echocardiography and closely agreed with the surgical findings.
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Affiliation(s)
- Vinod Patel
- Division of Cardiovascular Diseases, University of Alabama at Birmingham, Birmingham, Alabama 35249, USA
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Shih J, Ketchum D, Fyfe D. Two- and Three-Dimensional Echocardiographic Demonstration of a Left Main Coronary from the Right Sinus with Aneurysm in a Patient Presenting with Kawasaki Disease. Echocardiography 2006; 23:410-2. [PMID: 16686627 DOI: 10.1111/j.1540-8175.2006.00230.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Jennifer Shih
- Emory University Department of Pediatric Cardiology, Children's Healthcare of Atlanta, Emory University Medical Center, Atlanta, Georgia 30322, USA
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Hlavacek AM, Crawford FA, Chessa KS, Shirali GS. Real-Time Three-Dimensional Echocardiography Is Useful in the Evaluation of Patients with Atrioventricular Septal Defects. Echocardiography 2006; 23:225-31. [PMID: 16524393 DOI: 10.1111/j.1540-8175.2006.00193.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
OBJECTIVE We sought to determine whether three-dimensional echocardiography (3DE) is useful in the evaluation of patients with atrioventricular septal defect (AVSD). BACKGROUND Recent advances in 3DE have enhanced its practicality. We assessed whether 3DE provided new information compared to 2DE among patients with AVSD. METHODS We retrospectively reviewed 52 3DE datasets from 51 patients (median age: 4.6 years, range 0-30 years; median BSA: 0.6 m2, range 0.2-1.9 m2) with any type of AVSD during a 1-year period. 3DE findings were compared to 2DE and surgical reports. For each study, AVSD was classified by 2DE as one of the following: unrepaired balanced defect, repaired balanced defect with residual lesions, repaired balanced defect without residual lesions, or unbalanced defect. 3DE was graded as (1) Additive: 3DE resulted in a new finding or changed diagnosis; (2) Useful: While useful, 3DE did not result in new findings or changed diagnosis; or (3) Not useful. RESULTS 3DE on unrepaired balanced AVSD and repaired AVSD with residual lesions was more often additive/useful (33/36; 92%) than on repaired AVSD without residual lesions or unbalanced AVSD (9/16 (56%), P=0.009). 3DE was additive or useful in all three patients with unbalanced AVSD being considered for biventricular repair. Useful information obtained by 3DE included: precise characterization of mitral regurgitation and cleft leaflet, substrate for subaortic stenosis, valve anatomy, and presence and location of additional septal defects. CONCLUSION 3DE provides useful and additive information in unrepaired balanced AVSD, repaired AVSD with residual lesions, and unbalanced AVSD under consideration for biventricular repair.
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Affiliation(s)
- Anthony M Hlavacek
- Department of Pediatric Cardiology, Medical University of South Carolina, South Carolina 29425, USA
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Yelamanchili P, Nanda NC, Patel V, Bogabathina H, Baysan O. Definitive Diagnosis of Descending Thoracic Aortic Dissection by Real Time/Live Three-Dimensional Transthoracic Echocardiography. Echocardiography 2006; 23:158-61. [PMID: 16445737 DOI: 10.1111/j.1540-8175.2006.00201.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
We describe a patient with descending thoracic aortic dissection in whom three- dimensional transthoracic echocardiography was able to clearly visualize the dissection flap en face as a sheet of tissue, as well as demonstrate a large communication between the true and false lumen in three dimensions, enabling a definitive diagnosis of dissection.
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Affiliation(s)
- Pridhvi Yelamanchili
- Division of Cardiovascular Diseases, University of Alabama at Birmingham, Birmingham, Alabama 35249, USA
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Pothineni KR, Nanda NC, Patel V, Madadi P. Live/Real Time Three-Dimensional Transthoracic Echocardiographic Detection of Vegetation on a Pacemaker/Defibrillator Lead. ACTA ACUST UNITED AC 2006; 15:62-3. [PMID: 16415649 DOI: 10.1111/j.1076-7460.2006.04197.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Koteswara Rao Pothineni
- Division of Cardiovascular Diseases, University of Alabama at Birmingham, Birmingham, AL 35249, USA
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Patel V, Nanda NC, Rajdev S, Mehmood F, Velayudhan D, Vengala S, Copeland RB, Madadi P. RESEARCH FROM THE UNIVERSITY OF ALABAMA AT BIRMINGHAM: Live/Real Time Three-Dimensional Transthoracic Echocardiographic Assessment of Ebstein's Anomaly. Echocardiography 2005; 22:847-54. [PMID: 16343170 DOI: 10.1111/j.1540-8175.2005.00173.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
We describe our experience in using live/real time three-dimensional transthoracic echocardiography (3D TTE) in the assessment of five adult patients with Ebstein's anomaly. The technique was found useful in assessing the distribution and extent of tethering of each of the three leaflets of the tricuspid valve (TV) to the underlying right ventricular walls and the ventricular septum. The characteristic bubble-like appearance resulting from bulging of the non-tethered areas of the TV leaflets was also well visualized in three dimensions and their size measured. Thus, an estimate of the nontethered or free segments of all three leaflets of the TV could be obtained using this technique. This has important implications when considering these patients for surgical repair of the TV. Visualization of all three leaflets of the TV and their extent of tethering by 3D TTE also made it easier to identify the boundaries of the functioning right ventricular chamber potentially providing a more reliable assessment of its volumes and ejection fraction. Cropping of color Doppler 3D TTE data sets provided en face viewing of the TV regurgitation vena contracta permitting accurate assessment of its shape and size. This has the potential to provide a more accurate quantitative estimation of TV regurgitation severity as compared to two-dimensional color Doppler. In conclusion, live/real time 3D TTE appears useful in supplementing two-dimensional echocardiography in more comprehensively assessing the morphologic features of Ebstein's anomaly.
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Affiliation(s)
- Vinod Patel
- Division of Cardiovascular Diseases, University of Alabama at Birmingham, 35249, USA
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Upendram S, Nanda NC, Vengala S, Patel V, Mehmood F, Dod H, Bodiwala K, Frans E. Live Three-Dimensional Transthoracic Echocardiographic Assessment of Thrombus in the Innominate Veins and Superior Vena Cava Utilizing Right Parasternal and Supraclavicular Approaches. Echocardiography 2005; 22:445-9. [PMID: 15901300 DOI: 10.1111/j.1540-8175.2005.50023.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
We report the usefulness of right parasternal and supraclavicular live three-dimensional transthoracic echocardiography in the delineation and follow-up of a thrombus involving a catheter placed in superior vena cava for dialysis in an adult patient with chronic renal disease.
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Affiliation(s)
- Sailendra Upendram
- Division of Cardiovascular Diseases, The University of Alabama at Birmingham, Birmingham, Alabama 35249, USA
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Patel V, Nanda NC, Upendram S, Enar S, Mehmood F, Vengala S, Frans E, Bodiwala K. Live Three-Dimensional Right Parasternal and Supraclavicular Transthoracic Echocardiographic Examination. Echocardiography 2005; 22:349-60. [PMID: 15839993 DOI: 10.1111/j.1540-8175.2005.50022.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
In the present study, we describe the usefulness of the recently developed technique of live three-dimensional transthoracic echocardiography in the assessment of normal cardiac structures and adjacent vessels using the right parasternal and supraclavicular approaches. Examples of some abnormalities diagnosed from these approaches are also illustrated.
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Affiliation(s)
- Vinod Patel
- Division of Cardiovascular Diseases University of Alabama at Birmingham Birmingham, Alabama, USA
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Abstract
PURPOSE OF REVIEW Recent advances in the field of three-dimensional (3D) echocardiography have allowed improved visualization of cardiac structures. These advances have also provided valuable insights into cardiac function. The purpose of this review is to describe the recent developments in 3D echocardiography in assessing valvular heart disease. RECENT FINDINGS Application of 3D echocardiography to valvular heart disease has improved with advances made in both the hardware and software components of 3D ultrasound systems. The most significant advancement has been the development of a matrix transducer that is capable of rapid real-time 3D acquisition and rendering. There have been many studies evaluating 3D echocardiographic assessment of mitral valve disease, aortic valve disease, as well as congenital heart disease using both real-time 3D transthoracic echocardiography (TTE) as well as off-line reconstructed 3D images from transesophageal echocardiography (TEE) using post image processing. More recent studies have combined the structural 3D information with color Doppler 3D imaging, providing qualitative functional information. SUMMARY Developments in the field of 3D ultrasound imaging have allowed better qualitative assessment of valvular structures. The addition of color flow Doppler to the 3D imaging has provided improved visualization of regurgitant lesions and holds great promise for improved quantitative assessment of such lesions. The ongoing miniaturization of transducers and improvements in hardware and software components of ultrasound systems will certainly enhance both the ease of image acquisition as well as image quality, which should result in more precise quantitation of valvular dysfunction. However, clinical benefits of 3D echocardiography are yet to be demonstrated in properly conducted clinical trials, which are needed for wider acceptance of this technique.
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Affiliation(s)
- Omid Salehian
- Echocardiography Laboratory, Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
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Patel V, Nanda NC, Vengala S, Mehmood F, Frans E, Bodiwala K, Upendram S. Live Three-Dimensional Transthoracic Echocardiographic Demonstration of Septal Perforator Coronary Artery-Left Ventricle Fistulas Following Myectomy. Echocardiography 2005; 22:273-5. [PMID: 15725165 DOI: 10.1111/j.0742-2822.2005.40063.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
We present an adult patient with hypertrophic cardiomyopathy status post septal myectomy in whom live three-dimensional transthoracic echocardiography (3D TTE) demonstrated two septal perforator coronary arteries opening directly into the left-ventricular outflow tract. Only one of these fistulas could be demonstrated by two-dimensional transthoracic echocardiography (2D TTE). Our case demonstrates the potential usefulness of 3D TTE as a supplement to 2D TTE in the assessment of septal coronary artery-left ventricle fistulas.
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Affiliation(s)
- Vinod Patel
- Division of Cardiovascular Diseases, University of Alabama at Birmingham, Birmingham, Alabama, USA
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Mehmood F, Nanda NC, Vengala S, Winokur TS, Dod HS, Frans E, Patel V, Bodiwala K, Upendram S, Kirklin JK, McGiffin DC, Pacifico AD. Live Three-Dimensional Transthoracic Echocardiographic Assessment of Left Atrial Tumors. Echocardiography 2005; 22:137-43. [PMID: 15693780 DOI: 10.1111/j.0742-2822.2005.03088.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
This preliminary study demonstrates the superiority of live three-dimensional transthoracic echocardiography (3D TTE) over two-dimensional (2D) TTE in the assessment of left atrial (LA) tumors in four patients studied by us (three myxomas, one hemangioma, all subsequently pathologically proven). Because of the unique ability of live 3D TTE to systematically section and view the contents of an intracardiac mass, LA myxomas in the three patients studied could be more confidently diagnosed by noting isolated echolucent areas consistent with hemorrhage/necrosis in the tumor mass. On the other hand, a definite echolucent area was found by 2D TTE in only two of the three patients with myxoma. In the fourth patient with a hemangioma, live 3D TTE showed much more extensive and closely packed echolucencies with little solid tissue as compared to a myxoma consistent with a highly vascularized tumor. In contrast, 2D TTE demonstrated only two isolated echolucencies in the tumor suggesting an erroneous diagnosis of myxoma.
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Affiliation(s)
- Farhat Mehmood
- Division of Cardiovascular Diseases, University of Alabama at Birmingham, Birmingham, Alabama 35249, USA
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