title: Live/real time three-dimensional transesophageal echocardiographic assessment of ventricular septal volume and mass before and after myectomy in hypertrophic cardiomyopathy.
abstract: Hypertrophic cardiomyopathy (HCM) is the most common genetically transmitted cardiomyopathy. In patients resistant to medical management, myectomy is the surgical procedure of choice to reduce the symptoms of left ventricular outflow obstruction. Two-dimensional transesophageal echocardiography (2DTEE) has become part of the operative procedure by decreasing the incidence of postoperative complications. However, because of the three-dimensional geometry of left ventricular outflow tract, it is unable to comprehensively assess the location and severity of the obstruction and to provide accurate guidance during myectomy. In this study, 10 patients with HCM underwent live/real time three-dimensional transesophageal echocardiography (3DTEE) intra-operatively to measure the volume of the resected septum. This volume correlated well with the volume of the resected septal muscle directly obtained using a graduating cylinder containing water (r = 0.9, P < 0.000). 3DTEE may be potentially used as an adjunct to guide the surgeon in performing an adequate myectomy with a lower incidence of residual obstruction and complications such as an iatrogenic ventricular septal defect.
authors.affiliation: Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, Alabama.
authors.forename: Kamel
authors.initials: K
authors.lastname: Sadat
authors.forename: Hari Prakash
authors.initials: HP
authors.lastname: Diddi
authors.forename: Berthold
authors.initials: B
authors.lastname: Klas
authors.forename: Ayman Haj
authors.initials: AH
authors.lastname: Asaad
authors.forename: Elif İjlal
authors.initials: Eİ
authors.lastname: Çekirdekçi
authors.forename: Aylin
authors.initials: A
authors.lastname: Sungur
authors.forename: Selvin
authors.initials: S
authors.lastname: Sudhakar
authors.forename: Matthew
authors.initials: M
authors.lastname: Cain
authors.forename: Arshad
authors.initials: A
authors.lastname: Kamal
authors.forename: Navin C
authors.initials: NC
authors.lastname: Nanda
mesh_terms: D000328:Adult; D000368:Aged; D006348:Cardiac Surgical Procedures / Q000401:mortality; D002312:Cardiomyopathy, Hypertrophic / Q000000981:diagnostic imaging* / Q000601:surgery*; D004452:Echocardiography; D019560:Echocardiography, Three-Dimensional; D017548:Echocardiography, Transesophageal; D005260:Female; D006346:Heart Septum / Q000000981:diagnostic imaging* / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D009929:Organ Size; D011182:Postoperative Care; D011300:Preoperative Care; D016896:Treatment Outcome
keywords: hypertrophic cardiomyopathy; myectomy; real time three-dimensional transesophageal echocardiography; three-dimensional echocardiography; transesophageal echocardiography; transthoracic echocardiography