Case 1 - Cardiology Online
CLINICAL APPLICATIONS AND FUTURE OF 3D ECHOCARDIOGRAPHY
T. Shiota
Cedars-Sinai Heart Institute, Los Angeles, CA, USA
3D cardiac ultrasound is a promising imaging technology that is currently still in development, which can provide intuitive recognition of cardiac structures from any spatial point of view and may provide complete information about absolute heart chamber volumes and functions. In patients with localized left ventricular (LV) wall motion abnormalities, conventional 2D methods cannot be used to determine absolute LV volumes and ejection fraction (EF) because of the unpredictability of the asymmetric LV geometry. However, when the image quality is high enough with excellent time resolution, an analysis of localized LV wall motion by 3D echocardiography can reveal both true absolute LV volumes and localized wall motion abnormalities. In patients with mitral regurgitation, the location and shape of the mitral regurgitant orifice are essential information for determining the cause of regurgitation. Conventional 2D echocardiography often fails to show this information while 3D echocardiography images of the mitral valve with color Doppler capability can reveal even unexpected locations and shapes of the mitral regurgitant orifice. The recent development of real-time 3D transesophageal echocardiography (TEE) has provided excellent images of the mitral valve and insufficiency jets and flow convergences. 3D TEE with color Doppler capability has also allowed excellent guidance and monitoring of percutaneous closure procedures for mitral valve insufficiency, including para-valvular leaks. 3D echocardiography has shown unique capabilities for clarifying complicated cardiac anatomies and hemodynamics. Further development of real-time 3D echocardiography, including live color Doppler 3D TEE may result in widespread use of this method in routine clinical settings.
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