Advances in 3-D Echocardiography Cardiac Imaging Real-Time TEE of - PDF document

Advances in 3-D Echocardiography Cardiac Imaging Real-Time TEE of MV Focus On Valvular Heart Disease Mani A. Vannan, MBBS, FACC Professor of Clinical Medicine Joseph M. Ryan Chair in CV Medicine Director, Cardiovascular Imaging Ohio State University Medical Center LV View Surgical (Unroofed LA) View 3-D Echocardiography 2-D Echocardiography Real-Time TEE of MV Anatomy Real-Time TEE of MV • Obtainable in > 80% of TEE studies Courtesy: David Adams MD, Mt. Sinai Medical Center, NY 1

3-D Echocardiography 3-D Echocardiography Real-Time TEE of MV Anatomy Real-Time TEE of MV A B C P3 A1 P1 3 2 A P A2 A 1 A 3 A2 A3 A 2 P 3 P2 P 1 A1 P3 P1 P 2 Anatomical Orientation Transgastric Orientation Unroofed LA Orientation Let us see what 3-D offers: Demonstration JACC Imaging (in press): Figure from University of Chicago, Lang MD Live 3-D Echocardiography 2-D Echocardiography Real-Time TEE of Abnormal MV Impact on Clinical Practice What is the abnormal anatomy ? 2

3-D Echocardiography 2-D Echocardiography Real-Time TEE of Abnormal MV Real-Time TEE of Abnormal MV Anatomy Now what is the abnormal anatomy ? P2 and P3 Prolapse; maybe P1 also 3-D Echocardiography 3-D Echocardiography 2-D Vs. 3-D TEE for Real-Time TEE of Posterior MV Leaflet Prolapse Localization of Abnormal Anatomy in MV Repair Diastole Mid Systole Late Systole 3-D Vs 2-D TEE in MV repair, Garcia-Orta R et al, JASE 2007 20(1):4-12 3

3-D Echocardiography 3-D Echocardiography Real-Time TEE of Posterior MV Leaflet Prolapse Real-Time TEE of Mitral Leaflets and Annulus 3-D Echocardiography 3-D Echocardiography Localization and Quantification of MVP Volume Real-Time TEE of Mitral Leaflets and Annulus MVP Normal 4

Dilated Sino-Tubular Junction 3-D Echocardiography What Does The Surgeon Need From The Imager ? Quantitative Real-Time TEE of Mitral Leaflets and Ring Modified from: Tirone DE, JTCS1995; 109:345 Ascending Aortic Aneurysm 3-D TEE of Aortic Valve and Root What Does The Surgeon Need From The Imager ? 73 year old man, TEE for Moderate Aortic Regurgitation Modified from Tirone DE, Op Tech CTS 1996;1:44 Anderson RH doi:10.1510/mmcts.2006.002527 5

Ascending Aortic Aneurysm Quantitative 3-D Echocardiography of What Does The Surgeon Need From The Imager ? The Aortic Valve and Aortic Root Modified from Tirone DE, Op Tech CTS 1996;1:44 Anderson RH doi:10.1510/mmcts.2006.002527 3-D Automated Quantification of Aortic Valve and Root Modeling Aortic Valve and Root 3-D Echocardiography 4cm 2 6

3-D Automated Quantification of 3-D Automated Quantification of The Mitral Valve and The Aortic Root Aortic Valve and Root – TEE and CT Real-Time Volume Imaging 3-D Automated Quantification of Flow-Function The Mitral Valve 7

Real-Time Volume Imaging Real-Time Volume Imaging Flow-Function Flow-Function Real-Time Volume Imaging Real-Time Volume Imaging Flow-Function Flow-Function Courtesy – Nathalie DeMichelis 8

Real-Time Volume Imaging Real-Time Volume Imaging Flow-Function Flow-Function Courtesy – Nathalie DeMichelis Courtesy – Nathalie DeMichelis Real-Time Volume Imaging Flow-Function Courtesy – Nathalie DeMichelis 9