CLINICAL RESEARCH: CARDIAC IMAGING
Head-to-Head Comparison of Two- and Three-Dimensional Transthoracic and Transesophageal Echocardiography in the Localization of Mitral Valve Prolapse
Mauro Pepi, MD*,
Gloria Tamborini, MD,
Anna Maltagliati, MD,
Claudia Agnese Galli, MD,
Erminio Sisillo, MD,
Luca Salvi, MD,
Moreno Naliato, MD,
Massimo Porqueddu, MD,
Alessandro Parolari, MD,
Marco Zanobini, MD and
Francesco Alamanni, MD
Centro Cardiologico Monzino, IRCCS, Department of Cardiology and Cardiac Surgery, University of Milan, Milan, Italy.
Manuscript received December 19, 2005;
revised manuscript received February 24, 2006,
accepted February 28, 2006.
* Reprint requests and correspondence: Dr. Mauro Pepi, Centro Cardiologico, Via Parea 4, 20138 Milan, Italy. (Email: mauro.pepi{at}cardiologicomonzino.it).
OBJECTIVES: The aim of this study, undertaken in patients who underwent mitral valve (MV) repair surgery, was to evaluate the feasibility and accuracy of 3-dimensional (3D) transthoracic (TTE) and transesophageal (TEE) echocardiography in the evaluation of MV pathology.
BACKGROUND: A pre-operative assessment of MV anatomy is essential to surgical design in patients undergoing MV repair. Although 2-dimensional (2D) echocardiography provides precise information regarding MV anatomy, 3D TTE and 3D TEE could increase the understanding of MV apparatus and individual scallop identification.
METHODS: One-hundred-twelve consecutive patients with severe mitral regurgitation due to MV prolapse underwent a complete 2D and 3D TTE the day before surgery and a complete 2D and 3D TEE in the operating room. Echocardiographic data obtained by the different techniques were compared with surgical inspection.
RESULTS: Three-dimensional techniques were feasible in a relatively short time (3D TTE: 7 ± 4 min; 3D TEE: 8 ± 3 min), with good (3D TTE 55%; 3D TEE 35%) and optimal (3D TTE 21%; 3D TEE 45%) imaging quality in the majority of cases. Three-dimensional TEE allowed more accurate identification (95.6% accuracy) of all MV lesions in comparison with other techniques. Three-dimensional TTE and 2D TEE had similar accuracies (90% and 87%, respectively), whereas the accuracy of 2D TTE (77%) was significantly lower.
CONCLUSIONS: Three-dimensional TTE and TEE are feasible and useful methods in identifying the location of MV prolapse. They were superior in the description of pathology in comparison with the corresponding 2D techniques and should be regarded as an important adjunct to standard 2D examinations in decisions regarding MV repair.
|
Abbreviations and Acronyms
| | 2D = 2-dimensional | | 3D = 3-dimensional | | ALC = anterolateral commissure | | MV = mitral valve | | PMC = posteromedial commissure | | TEE = transesophageal echocardiography | | TTE = transthoracic echocardiography |
|
This article has been cited by other articles:
|
|
|
|
 
R. M. Lang, L. P. Badano, W. Tsang, D. H. Adams, E. Agricola, T. Buck, F. F. Faletra, A. Franke, J. Hung, L. P. de Isla, et al.
EAE/ASE Recommendations for Image Acquisition and Display Using Three-Dimensional Echocardiography
Eur Heart J Cardiovasc Imaging,
January 1, 2012;
13(1):
1 - 46.
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. S. Jassar, C. J. Brinster, M. Vergnat, J. D. Robb, T. J. Eperjesi, A. M. Pouch, A. T. Cheung, S. J. Weiss, M. A. Acker, J. H. Gorman III, et al.
Quantitative Mitral Valve Modeling Using Real-Time Three-Dimensional Echocardiography: Technique and Repeatability
Ann. Thorac. Surg.,
January 1, 2011;
91(1):
165 - 171.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. Chandra, I. S. Salgo, L. Sugeng, L. Weinert, W. Tsang, M. Takeuchi, K. T. Spencer, A. O'Connor, M. Cardinale, S. Settlemier, et al.
Characterization of Degenerative Mitral Valve Disease Using Morphologic Analysis of Real-Time Three-Dimensional Echocardiographic Images: Objective Insight Into Complexity and Planning of Mitral Valve Repair
Circ Cardiovasc Imaging,
January 1, 2011;
4(1):
24 - 32.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. H. Wong, A. P. Lee, C. S. Ng, I. Y. Wan, S. Wan, and M. J. Underwood
Mitral Valve Repair: Past, Present, and Future
Asian Cardiovasc Thorac Ann,
December 1, 2010;
18(6):
586 - 595.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
G. Tamborini, M. Muratori, A. Maltagliati, C. A. Galli, M. Naliato, M. Zanobini, F. Alamanni, L. Salvi, E. Sisillo, C. Fiorentini, et al.
Pre-operative transthoracic real-time three-dimensional echocardiography in patients undergoing mitral valve repair: accuracy in cases with simple vs. complex prolapse lesions
Eur Heart J Cardiovasc Imaging,
October 1, 2010;
11(9):
778 - 785.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. P.-W. Lee, Y.-Y. Lam, G. W.-K. Yip, R. M. Lang, Q. Zhang, and C.-M. Yu
Role of real time three-dimensional transesophageal echocardiography in guidance of interventional procedures in cardiology
Heart,
September 1, 2010;
96(18):
1485 - 1493.
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. H. Adams, R. Rosenhek, and V. Falk
Degenerative mitral valve regurgitation: best practice revolution
Eur. Heart J.,
August 2, 2010;
31(16):
1958 - 1966.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
F. A. Flachskampf, L. Badano, W. G. Daniel, R. O. Feneck, K. F. Fox, A. G. Fraser, A. Pasquet, M. Pepi, L. Perez de Isla, J. L. Zamorano, et al.
Recommendations for transoesophageal echocardiography: update 2010
Eur Heart J Cardiovasc Imaging,
August 1, 2010;
11(7):
557 - 576.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
P. Biaggi, M. Greutmann, A. Crean, M. Mezody, and H. Rakowski
A diagnostic odyssey: detection of an unusual anterior papillary muscle of the tricuspid valve
Eur Heart J Cardiovasc Imaging,
June 1, 2010;
11(5):
E19 - E19.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. Vegas and M. Meineri
Core Review: Three-Dimensional Transesophageal Echocardiography Is a Major Advance for Intraoperative Clinical Management of Patients Undergoing Cardiac Surgery: A Core Review
Anesth. Analg.,
June 1, 2010;
110(6):
1548 - 1573.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. M Johri, J. J Passeri, and M. H Picard
Three dimensional echocardiography: approaches and clinical utility
Heart,
March 1, 2010;
96(5):
390 - 397.
[Full Text]
[PDF]
|
|
|
|
|
|
|
L. D. Gillam and A. Schwartz
Primum Non Nocere: The Case for Watchful Waiting in Asymptomatic "Severe" Degenerative Mitral Regurgitation
Circulation,
February 16, 2010;
121(6):
813 - 821.
[Full Text]
[PDF]
|
|
|
|
|
|
|
N. A. Marsan, L. F Tops, P. Nihoyannopoulos, E. R Holman, and J. J Bax
Real-time three dimensional echocardiography: current and future clinical applications
Heart,
November 15, 2009;
95(22):
1881 - 1890.
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. Sonne, L. Sugeng, N. Watanabe, L. Weinert, K. Saito, M. Tsukiji, K. Yoshida, M. Takeuchi, V. Mor-Avi, and R. M. Lang
Age and body surface area dependency of mitral valve and papillary apparatus parameters: assessment by real-time three-dimensional echocardiography
Eur Heart J Cardiovasc Imaging,
March 1, 2009;
10(2):
287 - 294.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
F. A. Flachskampf, J.-U. Voigt, and W. G. Daniel
Chapter 4 Cardiac Ultrasound
ESC Textbook of Cardiovascular Medicine,
January 1, 2009;
2(1):
med-9780199566990-chapter - med-9780199566990-chapter.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
B. Jungwirth and G. B. Mackensen
Real-Time 3-Dimensional Echocardiography in the Operating Room
Seminars in Cardiothoracic and Vascular Anesthesia,
December 1, 2008;
12(4):
248 - 264.
[Abstract]
[PDF]
|
|
|
|
|
|
|
S. P. Hoole, T. V. Liew, J. Boyd, F. C. Wells, and R. A. Rusk
Transthoracic real-time three-dimensional echocardiography offers additional value in the assessment of mitral valve morphology and area following mitral valve repair
Eur Heart J Cardiovasc Imaging,
September 1, 2008;
9(5):
625 - 630.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
Y. Han, D. C. Peters, C. J. Salton, D. Bzymek, R. Nezafat, B. Goddu, K. V. Kissinger, P. J. Zimetbaum, W. J. Manning, and S. B. Yeon
Cardiovascular magnetic resonance characterization of mitral valve prolapse.
J. Am. Coll. Cardiol. Img.,
May 1, 2008;
1(3):
294 - 303.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
