Real-time 3-dimensional echocardiography in the operating room.
Real-time 3-dimensional transesophageal echocardiography (RT-3D-TEE) represents a novel clinical and intuitively educational perioperative cardiovascular imaging modality. The development of RT-3D-TEE allows for live 3D imaging as it circumvents most of the disadvantages of reconstructive 3D methods. RT-3D-TEE will likely revolutionize perioperative assessment of complex 3D structures, such as the mitral valve (MV), as it provides important mechanistic insights into functional and ischemic mitral regurgitation. The MV is particularly suited to live RT-3D-TEE assessment because of the complex interrelationships among the valve, chordae, papillary muscles, and myocardial walls. The 3D en face view of the MV is in accordance with the surgical view and allows to illustrate the unique saddle shape of the MV annulus and to define and localize mitral leaflet lesions in MV prolapse, endocarditis, or congenital MV abnormalities, all potentially important in guiding surgical repair. RT-3D-TEE will soon be integrated into routine perioperative practice. Its unique ability of real-time acquisition, online rendering and cropping capabilities, accurate identification of the precise pathology and location of cardiac disease, together with its ability to promptly quantify 3D data sets using built-in software, will likely help in transitioning this modality into standard of care.
Jungwirth
Bettina
B
Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina 27710, USA.
Mackensen
G Burkhard
GB
D001018:Aortic Diseases / Q000000981:diagnostic imaging; D001021:Aortic Valve / Q000000981:diagnostic imaging; D001022:Aortic Valve Insufficiency / Q000000981:diagnostic imaging; D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging; D019560:Echocardiography, Three-Dimensional / Q000379:methods*; D017548:Echocardiography, Transesophageal / Q000379:methods*; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging; D008946:Mitral Valve Stenosis / Q000000981:diagnostic imaging; D009873:Operating Rooms; D014261:Tricuspid Valve / Q000000981:diagnostic imaging; D016277:Ventricular Function, Left / Q000502:physiology