Usefulness of intraoperative real-time 3D transesophageal echocardiography in cardiac surgery.
BACKGROUND
Recent advances in three-dimensional (3D) echocardiography allow to obtain real-time 3D transesophageal (RT3DTEE) images intraoperatively.


METHODS
Preoperative transthoracic echocardiography (TTE) revealed: hypertrophic ventricular septum (TTE:19.3 mm), systolic anterior motion (SAM) not causing obstruction and malcoaptation of the anterior mitral valve leaflet (AMVL), and posterior mitral valve leaflet (PMVL) with severe mitral regurgitation.


RESULTS
Intraoperative TEE with a x7-2t MATRIX-array transducer (Philips, Andover, MA, USA) with a transducer frequency of x7-2 t mHz, connected to a iE33 (Philips), shows us that the main mechanism and site of regurgitation was an AMVL cleft. We also measured a 24.3-mm thickness of the ventricular septum and analyzing the 3D full volume acquisition revealed that there was no SAM.


CONCLUSIONS
Intraoperative RT3DTEE permitted comprehensive 3D viewing of the mitral valve revealing the mechanism of mitral valve regurgitation, SAM, and the exact width of the hypertrophic ventricular septum.
Scohy
Thierry V
TV
Department of Anaesthesiology, Erasmus Medical Center, Rotterdam, The Netherlands. t.scohy@erasmusmc.nl
Ten Cate
Folkert J
FJ
Lecomte
Patrick V E L
PV
McGhie
Jackie
J
de Jong
Peter L
PL
Hofland
Jan
J
Bogers
Ad J J C
AJ
D000328:Adult; D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D001022:Aortic Valve Insufficiency / Q000473:pathology / Q000601:surgery*; D003199:Computer Systems; D017548:Echocardiography, Transesophageal; D005260:Female; D006346:Heart Septum / Q000000981:diagnostic imaging; D006350:Heart Valve Prosthesis; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging; D017380:Hypertrophy, Right Ventricular / Q000000981:diagnostic imaging; D007432:Intraoperative Period; D008297:Male; D008943:Mitral Valve / Q000000981:diagnostic imaging; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging; D011237:Predictive Value of Tests; D013903:Thoracic Surgery / Q000379:methods*