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Role of modern 3D echocardiography in valvular heart disease.

Shiota T - Korean J. Intern. Med. (2014)

Bottom Line: Moreover, this method has become indispensable for nonsurgical mitral procedures such as edge to edge mitral repair and transcatheter closure of paravaluvular leaks.In addition, color Doppler 3D echo has been valuable to identify the location of the regurgitant orifice and the severity of the mitral regurgitation.However, the necessity of 3D echo is recognized for certain situations even for these valves, such as for evaluating the aortic annulus for transcatheter aortic valve implantation.

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine, Heart Institute, Cedars-Sinai Medical Center and University of California, Los Angeles, Los Angeles, CA, USA.

ABSTRACT
Three-dimensional (3D) echocardiography has been conceived as one of the most promising methods for the diagnosis of valvular heart disease, and recently has become an integral clinical tool thanks to the development of high quality real-time transesophageal echocardiography (TEE). In particular, for mitral valve diseases, this new approach has proven to be the most unique, powerful, and convincing method for understanding the complicated anatomy of the mitral valve and its dynamism. The method has been useful for surgical management, including robotic mitral valve repair. Moreover, this method has become indispensable for nonsurgical mitral procedures such as edge to edge mitral repair and transcatheter closure of paravaluvular leaks. In addition, color Doppler 3D echo has been valuable to identify the location of the regurgitant orifice and the severity of the mitral regurgitation. For aortic and tricuspid valve diseases, this method may not be quite as valuable as for the mitral valve. However, the necessity of 3D echo is recognized for certain situations even for these valves, such as for evaluating the aortic annulus for transcatheter aortic valve implantation. It is now clear that this method, especially with the continued development of real-time 3D TEE technology, will enhance the diagnosis and management of patients with these valvular heart diseases.

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A residual mitral regurgitation immediately after surgical mitral valve replacement (a tissue valve). (A) The upper panel shows 2-dimensional (D) transesophageal echocardiography (TEE) image. (B) Color Doppler 3D TEE image could demonstrate the exact location of the residual mitral regurgitation (MR) (arrow) which could assist in second pump correction of the MR. AP, appendage; AV, aortic valve; MV, mitral valve.
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Figure 6: A residual mitral regurgitation immediately after surgical mitral valve replacement (a tissue valve). (A) The upper panel shows 2-dimensional (D) transesophageal echocardiography (TEE) image. (B) Color Doppler 3D TEE image could demonstrate the exact location of the residual mitral regurgitation (MR) (arrow) which could assist in second pump correction of the MR. AP, appendage; AV, aortic valve; MV, mitral valve.

Mentions: Regarding postoperative evaluation of MV repair or replacement, 3D TEE has been shown to facilitate visualization of the entire structure of the new artificial valve [65]. In addition, color Doppler 3D TEE can delineate the location of the paravalvular MR, especially useful for transcatheter closure of the leak [65,66,67,68]. In our study, color Doppler 3D TEE showed the exact location of the circumferential orifice of paravalvular regurgitation around the artificial MV, thus assisting the transcatheter device closure procedure [66]. Fig. 6 shows a case of postoperative residual paravalvular MR. Color Doppler 3D TEE showed the exact location of the residual MR, which allowed immediate successful surgical correction (Fig. 6).


Role of modern 3D echocardiography in valvular heart disease.

Shiota T - Korean J. Intern. Med. (2014)

A residual mitral regurgitation immediately after surgical mitral valve replacement (a tissue valve). (A) The upper panel shows 2-dimensional (D) transesophageal echocardiography (TEE) image. (B) Color Doppler 3D TEE image could demonstrate the exact location of the residual mitral regurgitation (MR) (arrow) which could assist in second pump correction of the MR. AP, appendage; AV, aortic valve; MV, mitral valve.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4219957&req=5

Figure 6: A residual mitral regurgitation immediately after surgical mitral valve replacement (a tissue valve). (A) The upper panel shows 2-dimensional (D) transesophageal echocardiography (TEE) image. (B) Color Doppler 3D TEE image could demonstrate the exact location of the residual mitral regurgitation (MR) (arrow) which could assist in second pump correction of the MR. AP, appendage; AV, aortic valve; MV, mitral valve.
Mentions: Regarding postoperative evaluation of MV repair or replacement, 3D TEE has been shown to facilitate visualization of the entire structure of the new artificial valve [65]. In addition, color Doppler 3D TEE can delineate the location of the paravalvular MR, especially useful for transcatheter closure of the leak [65,66,67,68]. In our study, color Doppler 3D TEE showed the exact location of the circumferential orifice of paravalvular regurgitation around the artificial MV, thus assisting the transcatheter device closure procedure [66]. Fig. 6 shows a case of postoperative residual paravalvular MR. Color Doppler 3D TEE showed the exact location of the residual MR, which allowed immediate successful surgical correction (Fig. 6).

Bottom Line: Moreover, this method has become indispensable for nonsurgical mitral procedures such as edge to edge mitral repair and transcatheter closure of paravaluvular leaks.In addition, color Doppler 3D echo has been valuable to identify the location of the regurgitant orifice and the severity of the mitral regurgitation.However, the necessity of 3D echo is recognized for certain situations even for these valves, such as for evaluating the aortic annulus for transcatheter aortic valve implantation.

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine, Heart Institute, Cedars-Sinai Medical Center and University of California, Los Angeles, Los Angeles, CA, USA.

ABSTRACT
Three-dimensional (3D) echocardiography has been conceived as one of the most promising methods for the diagnosis of valvular heart disease, and recently has become an integral clinical tool thanks to the development of high quality real-time transesophageal echocardiography (TEE). In particular, for mitral valve diseases, this new approach has proven to be the most unique, powerful, and convincing method for understanding the complicated anatomy of the mitral valve and its dynamism. The method has been useful for surgical management, including robotic mitral valve repair. Moreover, this method has become indispensable for nonsurgical mitral procedures such as edge to edge mitral repair and transcatheter closure of paravaluvular leaks. In addition, color Doppler 3D echo has been valuable to identify the location of the regurgitant orifice and the severity of the mitral regurgitation. For aortic and tricuspid valve diseases, this method may not be quite as valuable as for the mitral valve. However, the necessity of 3D echo is recognized for certain situations even for these valves, such as for evaluating the aortic annulus for transcatheter aortic valve implantation. It is now clear that this method, especially with the continued development of real-time 3D TEE technology, will enhance the diagnosis and management of patients with these valvular heart diseases.

Show MeSH
Related in: MedlinePlus