Salustri A. Spitaels S. McGhie J. Vletter W. Roelandt JR.
Title
Transthoracic three-dimensional echocardiography in adult patients with congenital heart disease.
Source
Journal of the American College of Cardiology. 26(3):759-67, 1995 Sep.
Abstract
OBJECTIVES. This study sought to assess both the feasibility and potential
role of transthoracic three-dimensional echocardiography for the
evaluation of adult patients with congenital heart disease. BACKGROUND.
The unrestricted views with depth perception provided by three-dimensional
echocardiography with dynamic volume-rendered display may enhance
visualization of cardiac structures and detection of abnormalities in
patients with congenital heart defects. METHODS. We studied 33 patients
with various heart defects (mitral valve anomalies in 9, aortic valve
anomalies in 5, subaortic membrane in 5, ventricular septal defect in 4,
transposition of the great arteries in 3, tetralogy of Fallot in 2, other
defects in 5). Cross-sectional images of the specific region of interest
were acquired from either the parasternal or apical window with the
rotational technique (2 degrees interval with electrocardiographic and
respiratory gating) and postprocessed for resampling in cubic format. From
these three-dimensional data sets a multitude of cut planes were selected,
presented in volume-rendered dynamic display and analyzed by two observers
for comparison with standard two-dimensional images to assess their
additional information. RESULTS. Three-dimensional reconstruction was
possible in all patients. Structures of interest were evaluated from
unusual viewpoints, providing both cardiologists and surgeons with
immediate feedback. When compared with standard two-dimensional images,
additional information was provided for 12 patients (36%). The mitral
valve, aortoseptal continuity and interatrial septum were the structures
for which three-dimensional echocardiography was most useful. CONCLUSIONS.
Transthoracic three-dimensional echocardiography is feasible and
facilitates spatial recognition of the intracardiac anatomy in a
significant proportion of patients and enhances diagnostic confidence of
complex congenital heart disease.