ABSTRACT
Objective To evaluate the usefulness of real-time three-dimensional transesophageal echocardiography(RT-3D-TEE)in cardiac valvular diseases.Methods Preoperative and postoperative RT-3D-TEE studies were performed in 32 patients who had undertaken cardiac valve repair or valvular replacement using Philips iE33 with X7-2 probe,and quantitative analysed the mitral structure in cases of mitral valve prolapse by using online QLAB7.0 quantitative analysis software.Results RT-3D-TEE can demonstrate the anatomicsl structure clearly,evaluate the function of cardiac valves precisely,and reveal details of type,position and extent of lesions vividly in surgical view.RT-3D-TEE helped correct misdiagnose in 2 cases,revised surgical plans in 3 cases,and guided implementation of remedial surgery in 1 case.Conclusions RT-3D-TEE can present images lively,and it can provide adequate information for preoperative diagnosis,aid the formulation of surgical plan and evaluate surgical effect.
ABSTRACT
Objective To research the feasibility and accuracy on echocardiography measurement aortic annulus diameter(AAD)at the plane of three Junctions of aortic valve leaflets by real-time three-dimensional transesophageal echocardiography(RT-3D-TEE).Methods Twenty-three patients underwent echocardiography and aortic valve replacement because of acquired aortic valve disease.The AAD was measured in parasternal left ventricle long axis view(TTE-AAD)by transthoracic echocardiography(TTE)preoperative.The AAD was measured in left ventricle long axis view(TEE-AAD)and the distance of three iunctions of aortic valve leaflets (N,L,R) was measured in aortic short axis view by RT-3D-TEE intraoperative.The three-dimensional full volume images were analyzed by online QLAB 7.0 software.The AAD was measured by standard cylindrical valve sizer (OP-AAD)before aortic valve replacement surgery,too.Results Comparing with the three aortic valve leaflets of acquired aortic valve disease,the lines between their junctions constituted an approximate equilateral triangle regardless of the cause and degree of disease,and the length of the three groups was no significant difference(P>0.05).There was no significant difference between TTE-AAD and OP-AAD group(P>0.05),and the correlation was good(r=0.84).The N,L and R group compared separately with the OP-AAD group, there was no significant difference(P>0.05)and correlation was superior to TTE-AAD group(r=0.94, 0.97, 0.96).The difference between TEE-AAD and OP-AAD were significant(P<0.01).Conclusions Echocardiography measurement of AAD at the plane of three junctions of aortic valve leaflets is feasible,and it is better accuracy and repeatability comparing with parasternal left ventricle long axis view.
ABSTRACT
Background and objective Pre-operative assessment of mitral valve(MV)anatomy is essential to surgical design in patientsundergoing MV repair.Although 2-dimensional(2D)echocardiography provides precise information regarding MV anatomy,RT-3DTEE could increase the understanding of MV apparatus and individual scallop identification.We aimed to investigate the value of RT-3DTEE in MV repair. Methods RT-3DTEE was performed in six patients with mitral valve prolapse(MVP) by using Philips IE33with X7-2t probe.Preoperative RT-3DTEE studies were compared with surgical findings in patients undergoing surgical mitral valverepair,and quantitative evaluation was performed by QLab 6.0 software before and after surgicalmitralvalve repair.Results RT-3DTEE could display dynamic morphology of MV,the location of prolapse,and spatial relation to the surrounding tissue.It couldprovide surgical views of the valves and the valvular apparatus.These resuIts were consistent with surgical findings.The quantitativeevahuation before and after surgical MV repair indicated that anterolateral to posteromedial diameter of annalus.anterior to posteriordiameter of annulus,perimeter of annullus.,and area of annalus in projectionplane were significantlv smaller after operation comparedwith those before operation(P＜0.05).The length of posterior leaflet,,the area of anterior and posterior leaflet,the maximal prolapseheight,the volume of leaflet prolapse and the length of coaptation in projection planewere significantly reduced after operation(P＜0.05).Conclusion RT-3DTEE is a unique new medality for rapid and accurate evaluation of mitral valve prolapse and miwal valverepair.
ABSTRACT
Atrial flutter, a common rhythm disturbance, was first described over 80 years ago. Despite extensive investigations, several important issues remain unresolved concerning its exact mechanism and management. Present therapeutic strategies often appear effective to prevent and terminate atrial flutter. However, controlled trial and definitive studies comparing the various treatment options are surprisingly scarce. Here we report on a study of 9 episodes of spontaneous atrial flutter(AF)(flutter wave cycle length 224+/-39 msec) treatedd by transesophageal atrial pacing(TAP) in 9 patients(7 men and 2 women; mean age 56.9 yrs). TAP was effective in 5 patients : sinus rhythm resumption was immediate in 3 patients and followed a short period of atrial fibrillation in 2 patients. TAP was unsuccessful in 4 patients. All the patients tolerated the procedure well. These data strongly support the immediate first choice use of TAP in AF therapy.