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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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Reconstructed normal tricuspid annulus with the use of (A) 3-dimensional (D) echocardiography and (B) its application to the development of a new 3D ring for surgical annuloplasty. A, anterior; L, lateral; P, posterior; S, septal.
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Figure 13: Reconstructed normal tricuspid annulus with the use of (A) 3-dimensional (D) echocardiography and (B) its application to the development of a new 3D ring for surgical annuloplasty. A, anterior; L, lateral; P, posterior; S, septal.

Mentions: The geometry and size of the tricuspid annulus have been investigated using 3D echocardiography [101,102,130,131,132,133]. We found that a normal tricuspid annulus has a unique 3D geometry (Fig. 13) [130]. With the 3D geometric concept, a new annuloplasty ring for a tricuspid annulus was developed and used in patients with severe TR (Fig. 12) [134]. Short term results with this new annuloplasty ring appear to be satisfactory [135]. Three-dimensional echocardiography has been valuable not only for understanding complicated cardiac structures but also for developing new strategies, such as this new annuloplasty ring, for treatment of patients.


Role of modern 3D echocardiography in valvular heart disease.

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

Reconstructed normal tricuspid annulus with the use of (A) 3-dimensional (D) echocardiography and (B) its application to the development of a new 3D ring for surgical annuloplasty. A, anterior; L, lateral; P, posterior; S, septal.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 13: Reconstructed normal tricuspid annulus with the use of (A) 3-dimensional (D) echocardiography and (B) its application to the development of a new 3D ring for surgical annuloplasty. A, anterior; L, lateral; P, posterior; S, septal.
Mentions: The geometry and size of the tricuspid annulus have been investigated using 3D echocardiography [101,102,130,131,132,133]. We found that a normal tricuspid annulus has a unique 3D geometry (Fig. 13) [130]. With the 3D geometric concept, a new annuloplasty ring for a tricuspid annulus was developed and used in patients with severe TR (Fig. 12) [134]. Short term results with this new annuloplasty ring appear to be satisfactory [135]. Three-dimensional echocardiography has been valuable not only for understanding complicated cardiac structures but also for developing new strategies, such as this new annuloplasty ring, for treatment of patients.

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