Epicardial real-time 3-dimensional echocardiography with the use of a pediatric transthoracic probe: a technical approach.
OBJECTIVE
The aim of the present study was to suggest a simple and comprehensive method for performing real-time 3-dimensional (3D) epicardial echocardiography with a pediatric probe small enough for the surgical field. Intraoperative echocardiography is a necessary tool for planning and performing cardiac surgery. Although epicardial intraoperative echocardiography is intended for few patients, it is a part of an exhaustive approach to intraoperative echocardiography.


METHODS
An observational feasibility study.


METHODS
A community hospital, single-institutional study.


METHODS
Eighty consecutive adult patients undergoing cardiac surgery.


METHODS
All patients were examined with 3D epicardial echocardiography before and after cardiopulmonary bypass; x-plane, live 3D, and 3D full-volume imaging modalities were systematically recorded. Feasibility and acquisition time were assessed. The image quality was evaluated by 3 independent surgeons.


RESULTS
Four sequential positions were determined to achieve a complete 3D heart examination focused on the structure of most interest. Acquisition plus elaboration did not require more than 20 minutes.


CONCLUSIONS
Three-dimensional epicardial echocardiography is feasible, and in the x-plane modality it is quicker than standard epicardial 2-dimensional examination. According to the judgment of independent observers, it provides high-quality and reproducible images, which are particularly valuable for mitral valve repair.
Salandin
Valeria
V
Santa Maria dei Battuti Hospital, Piazza dell'Opsedale 1, 35100 Treviso, Italy. vsalandin@ulss.tv.it
De Castro
Stefano
S
Cavarretta
Elena
E
Salvador
Loris
L
Papetti
Federica
F
Valfrè
Carlo
C
Pandian
Natesa G
NG
D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging; D002315:Cardiopulmonary Bypass; D003199:Computer Systems; D004311:Double-Blind Method; D019560:Echocardiography, Three-Dimensional / Q000379:methods*; D017548:Echocardiography, Transesophageal / Q000379:methods*; D005240:Feasibility Studies; D006801:Humans; D008488:Medical Illustration; D008875:Middle Aged; D008946:Mitral Valve Stenosis / Q000000981:diagnostic imaging; D016343:Monitoring, Intraoperative / Q000295:instrumentation* / Q000379:methods; D010496:Pericardium; D025321:Surgery, Computer-Assisted / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging