title: Incremental value of three-dimensional transesophageal echocardiography over two-dimensional transesophageal echocardiography in the assessment of Lambl's excrescences and nodules of Arantius on the aortic valve.
abstract: In this retrospective study, we identified 7 cases where Lambl's excrescences were identified by two-dimensional transesophageal echocardiography (2DTEE) and also had live/real time three-dimensional transesophageal echocardiography (3DTEE) studies available for comparison. We subsequently assessed them for the presence of Lambl's excrescences (LE) and nodules of Arantius (NA) on the aortic valve. After their identification, we qualitatively and quantitatively organized our findings by number, cusp location, measurements, and orientation if applicable. A greater number of LE was found by 3DTEE than 2DTEE (19 vs. 11, respectively). In all 3DTEE studies, their cusp attachment site, their x-, y-, and z-axis measurements, and orientation were clearly visualized and described. Only 3DTEE studies provided confident visualization of the cusp attachment sites. Similarly, a greater number of NA was found by 3DTEE than 2DTEE (21 vs. 5, respectively). The triad of NA was visualized in all 3DTEE studies and each was described using its x-, y-, and z- axis measurements. Only three 2DTEE studies provided reliable identification of the NA. In conclusion, we present further evidence of the incremental value of 3DTEE over 2DTEE in the qualitative and quantitative assessment of cardiac structures including LE and NA on the aortic valve.
authors.affiliation: Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, Alabama.
authors.forename: Bhavin
authors.initials: B
authors.lastname: Dumaswala
authors.forename: Komal
authors.initials: K
authors.lastname: Dumaswala
authors.forename: Ming Chon
authors.initials: MC
authors.lastname: Hsiung
authors.forename: Luis David Meggo
authors.initials: LD
authors.lastname: Quiroz
authors.forename: Aylin
authors.initials: A
authors.lastname: Sungur
authors.forename: Maximilliano German Amado
authors.initials: MG
authors.lastname: Escanuela
authors.forename: Kruti
authors.initials: K
authors.lastname: Mehta
authors.forename: Tugba Kemaloglu
authors.initials: TK
authors.lastname: Oz
authors.forename: Kunal
authors.initials: K
authors.lastname: Bhagatwala
authors.forename: Nidhi M
authors.initials: NM
authors.lastname: Karia
authors.forename: Navin C
authors.initials: NC
authors.lastname: Nanda
mesh_terms: D000368:Aged; D000465:Algorithms; D001021:Aortic Valve / Q000000981:diagnostic imaging*; D000082882:Bicuspid Aortic Valve Disease; D004452:Echocardiography / Q000379:methods*; D019560:Echocardiography, Three-Dimensional / Q000379:methods*; D017548:Echocardiography, Transesophageal / Q000379:methods*; D005260:Female; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging*; D006349:Heart Valve Diseases / Q000000981:diagnostic imaging*; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
keywords: Lambl's excrescences; aortic valve; echocardiography; nodules of Arantius; three-dimensional echocardiography; three-dimensional transesophageal echocardiography; two-dimensional transesophageal echocardiography