Morphology and dynamic change of discrete subaortic stenosis can be imaged and quantified with three-dimensional transesophageal echocardiography.
This report describes three-dimensional transesophageal echocardiographic findings in three consecutive patients with discrete subaortic stenosis. The discrete subaortic stenosis lesions included a circumferential, a remnant crescent, and a broken fibrotic subaortic membrane. The lesions were best imaged by using a three-dimensional transesophageal echocardiography-generated "aortotomy view" of the left ventricular outflow tract immediately below the plane of the aortic valve. The three-dimensional images correlated well with surgical and pathologic findings. The three-dimensional surface areas of the left ventricular outflow tract at the level of discrete subaortic stenosis during systole (0.8 +/- 0.5 cm2) and diastole (1.7 +/- 0.7 cm2) were measured by planimetry of the three-dimensional transesophageal echocardiographic images. The novel "aortotomy view" offered by three-dimensional transesophageal echocardiography provided direct visualization and quantification of discrete subaortic stenosis in a dynamic fashion. In summary, three-dimensional transesophageal echocardiography can accurately display and quantify discrete subaortic stenosis and could be a new clinically useful tool for assessing discrete subaortic stenosis and guiding surgical and transcatheter interventions.
Ge
S
S
Department of Internal Medicine, Bowman Gray School of Medicine of Wake Forest University, NC 27157-1045, USA.
Warner
J G
JG
Fowle
K M
KM
Kon
N D
ND
Brooker
R F
RF
Nomeir
A M
AM
Kitzman
D W
DW
D000328:Adult; D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D001022:Aortic Valve Insufficiency / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D006328:Cardiac Catheterization; D003971:Diastole; D015150:Echocardiography, Doppler; D019560:Echocardiography, Three-Dimensional; D017548:Echocardiography, Transesophageal; D005260:Female; D005355:Fibrosis; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging; D013599:Systole