Pre-operative transthoracic live three-dimensional echocardiography in the assessment of mitral stenosis: clinical experience
September 6, 2012
Pre-operative transthoracic live three-dimensional echocardiography in the assessment of mitral stenosis: clinical experience
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Title: | Pre-operative transthoracic live three-dimensional echocardiography in the assessment of mitral stenosis: clinical experience |
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Article_Title: | Pre-operative transthoracic live three-dimensional echocardiography in the assessment of mitral stenosis: clinical experience |
Authors: | Penteridis Ioannis, Mornoş Cristian, Ionac Adina, Feier Horia, Gaspar Marian, Drăgulescu Ştefan Iosif |
Affiliation: | Victor Babes University of Medicine and Pharmacy, Timisoara, IInd Cardiology Clinic, IInd Cardiovascular Surgery Clinic. |
Abstract: | We investigated three-dimensional (3D) live transthoracic echocardiography (TTE) in the assessment of mitral stenosis. Bidimensional (2D) TTE and 3D TEE was performed in 42 patients with mitral stenosis concomitent with cardiac catheterisation, prior to valve surgery. Using a surgical scoring protocol for recognition of the valvular segments, 2D and 3D methods were compared. Adequate echocardiographic visualization of the mitral segments was more frequently obtained by 3D TTE than by 2D TTE. Total 3D TTE score were significantly better than 2D TTE score. Using surgical classification as gold standard, the sensibility and specificity were 93% and 87 % for 3D TEE, and 86% and 79% for 2D TTE. The opening area determined by 3D TEE showed better linear association with the area determined intraoperative or invasively by Gorlin formula compared with 2D TTE. In conclusions, 3D TTE was superior to 2D TTE for the analysis of mitral stenosis and could be used for the accurate identification of the severity. |
Keywords: | mitral valve stenosis, mitral valve area, three-dimensional live transthoracic echocardiography, bidimensional transthoracic echocardiography, Gorlin formula. |
References: | Binder T.M., Rosenhek R., Porenta G., Maurer G., Baumgartner H., Improved assessment of mitral valve stenosis by volumetric real-time threedimensional echocardiography J Am Coll Cardiol, 36(4),1355-61, 2000. Bonow R.O., Carabello B.A., Chatterjee K., de Leon A. Jr, Faxon D.P., Freed M.D., et al, 2008 focused update incorporated into the ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to revise the 1998 guidelines for the management of patients with valvular heart disease). Endorsed by the Society of Cardiovascular Anesthesiologists,Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons, J Am Coll Cardiol 52, e1–142, 2008. Carabello B.A., Advances in the hemodynamic assessment of stenotic cardiac valves, J Am Coll Cardiol, 10, 912–9, 1987. Carpentier A., Cardiac valve surgery-the ‘French correction’. J Thorac Cardiovasc Surg, 86, 323–37, 1983. Chu J.W., Levine R.A., Chua S., Poh K.K., Morris E., Hua L., et al., Assessing mitral valve area and orifice geometry in calcific mitral stenosis: a new solution by real-time three-dimensional echocardiography, J Am Soc Echocardiogr, 21(9), 1006-9, 2008. García-Fernández M.A., Cortés M., García-Robles J.A., Gomez de Diego J.J., Perez-David E., García E., Utility of real-time three-dimensional transesophageal echocardiography in evaluating the success of percutaneous transcatheter closure of mitral paravalvular leaks, J Am Soc Echocardiogr, 23(1),26-32, 2010. Garcia-Orta R., Moreno E., Vidal M., Ruiz-Lopez F., Oyonarte J., Lara J., et al., Threedimensional versus two-dimensional transesophageal echocardiography in mitral valve repair, J Am Soc Echocardiogr, 20, 4–12, 2007. Hoole S.P., Liew T.V., Boyd J., Wells F.C., Rusk R.A., Transthoracic real-time three-dimensional echocardiography offers additional value in the assessment of mitral valve morphology and area following mitral valve repair. Eur J Echocardiogr, 9(5), 625-30, 2008. Iung B., Baron G., Butchart E.G., Delahaye F., Gohlke- Barwolf C., Levang O.W., et al., A prospective survey of patients with valvular heart disease in Europe: The Euro Heart Survey on Valvular Heart Disease, Eur Heart J, 24, 1231–43, 2003. Khaw A.V., von Bardeleben R.S., Strasser C., Mohr- Kahaly S., Blankenberg S., Espinola-Klein C., et al., Direct measurement of left ventricular outflow tract by transthoracic real-time 3D-echocardiography increases accuracy in assessment of aortic valve stenosis, Int J Cardiol, 136, 64–71, 2009. Kondur A., Pitta S., Afonso L., Incremental utility of real-time three-dimensional echocardiography in the diagnosis and preoperative assessment of cleft mitral valve in adults, Eur J Echocardiogr, 9, 586–8, 2008. Muller S., Muller L., Laufer G., et al., Comparison of three-dimensional imaging to transesophageal echocardiography for preoperative evaluation in mitral valve prolapse, Am J Cardiol, 98, 243–48, 2006. Nichol P.M., Gilbert B.W., Kisslo J.A., Two-dimensional echocardiographic assessment of mitral stenosis. Circulation, 55, 120–8, 1977. Pandian N.G., Roelandt J.R.T.C., Nanda N.C., Sugeng L., Cao Q.L., Azevedo J., et al., Dynamic threedimensional echocardiography: methods and clinical potential, Echocardiogaphy, 11, 237e59, 1994. Pepi M., Tamborini G., Maltagliati A., Galli C.A., Sigillo E., Salvi L., et al., Head-to-head comparison of two- and three-dimensional transthoracic and transesophageal echocardiography in the localization of mitral valve prolapse, J Am Coll Cardiol, 48, 2524–30, 2006. Solis J., Sitges M., Levine R.A., Hung J., Threedimensional echocardiography. New possibilities in mitral valve assessment. Rev Esp Cardiol, 62(2),188-98, 2009. Tamborini G., Muratori M., Maltagliati A., Galli C.A., Naliato M., Zanobini M., 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 J Echocardiogr, 11(9),778-85, 2010. Uno K., Takenaka K., Ebihara A., Nawata K., Hayashi N., Nagasaki M., et al., Value of live 3D transoesophageal echocardiography in the diagnosis of mitral valve lesions, Eur J Echocardiogr, 10, 350–1, 2009. Zamorano J., Cordeiro P., Sugeng L., Perez de Isla L., Weinert L., Macaya C., et al., Real-time threedimensional echocardiography for rheumatic mitral valve stenosis evaluation: an accurate and novel approach, J Am Coll Cardiol, 43(11), 2091-6, 2004. Vahanian A., Baumgartner H., Bax J., Butchart E., Dion R., Filippatos G., et al., Guidelines on the management of valvular heart disease: The Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology, Eur Heart J, 28, 230–68, 2007. Wei J., Hsiung M.C., Tsai S.K., Ou C.H., Chang C.Y., Chang Y.C., et al., The routine use of live threedimensional transesophageal echocardiography in mitral valve surgery: clinical experience, Eur J Echocardiogr, 11, 14–8, 2010. |
Read_full_article: | pdf/22-2012/22-1-2012/SU22-1-2012-Penteridis.pdf |
Correspondence: | Cristian Mornos, MD, PhD, Victor Babes University of Medicine and Pharmacy, Timişoara Institute of Cardiovascular Disease, 13 A Gh. Adam st., tel: +40 256207363, fax: +40 256207362, mobile: +40744790381 e-mail: mornoscristi@yahoo.com |
Read full article | |
Article Title: | Pre-operative transthoracic live three-dimensional echocardiography in the assessment of mitral stenosis: clinical experience |
Authors: | Penteridis Ioannis, Mornoş Cristian, Ionac Adina, Feier Horia, Gaspar Marian, Drăgulescu Ştefan Iosif |
Affiliation: | Victor Babes University of Medicine and Pharmacy, Timisoara, IInd Cardiology Clinic, IInd Cardiovascular Surgery Clinic. |
Abstract: | We investigated three-dimensional (3D) live transthoracic echocardiography (TTE) in the assessment of mitral stenosis. Bidimensional (2D) TTE and 3D TEE was performed in 42 patients with mitral stenosis concomitent with cardiac catheterisation, prior to valve surgery. Using a surgical scoring protocol for recognition of the valvular segments, 2D and 3D methods were compared. Adequate echocardiographic visualization of the mitral segments was more frequently obtained by 3D TTE than by 2D TTE. Total 3D TTE score were significantly better than 2D TTE score. Using surgical classification as gold standard, the sensibility and specificity were 93% and 87 % for 3D TEE, and 86% and 79% for 2D TTE. The opening area determined by 3D TEE showed better linear association with the area determined intraoperative or invasively by Gorlin formula compared with 2D TTE. In conclusions, 3D TTE was superior to 2D TTE for the analysis of mitral stenosis and could be used for the accurate identification of the severity. |
Keywords: | mitral valve stenosis, mitral valve area, three-dimensional live transthoracic echocardiography, bidimensional transthoracic echocardiography, Gorlin formula. |
References: | Binder T.M., Rosenhek R., Porenta G., Maurer G., Baumgartner H., Improved assessment of mitral valve stenosis by volumetric real-time threedimensional echocardiography J Am Coll Cardiol, 36(4),1355-61, 2000. Bonow R.O., Carabello B.A., Chatterjee K., de Leon A. Jr, Faxon D.P., Freed M.D., et al, 2008 focused update incorporated into the ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to revise the 1998 guidelines for the management of patients with valvular heart disease). Endorsed by the Society of Cardiovascular Anesthesiologists,Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons, J Am Coll Cardiol 52, e1–142, 2008. Carabello B.A., Advances in the hemodynamic assessment of stenotic cardiac valves, J Am Coll Cardiol, 10, 912–9, 1987. Carpentier A., Cardiac valve surgery-the ‘French correction’. J Thorac Cardiovasc Surg, 86, 323–37, 1983. Chu J.W., Levine R.A., Chua S., Poh K.K., Morris E., Hua L., et al., Assessing mitral valve area and orifice geometry in calcific mitral stenosis: a new solution by real-time three-dimensional echocardiography, J Am Soc Echocardiogr, 21(9), 1006-9, 2008. García-Fernández M.A., Cortés M., García-Robles J.A., Gomez de Diego J.J., Perez-David E., García E., Utility of real-time three-dimensional transesophageal echocardiography in evaluating the success of percutaneous transcatheter closure of mitral paravalvular leaks, J Am Soc Echocardiogr, 23(1),26-32, 2010. Garcia-Orta R., Moreno E., Vidal M., Ruiz-Lopez F., Oyonarte J., Lara J., et al., Threedimensional versus two-dimensional transesophageal echocardiography in mitral valve repair, J Am Soc Echocardiogr, 20, 4–12, 2007. Hoole S.P., Liew T.V., Boyd J., Wells F.C., Rusk R.A., Transthoracic real-time three-dimensional echocardiography offers additional value in the assessment of mitral valve morphology and area following mitral valve repair. Eur J Echocardiogr, 9(5), 625-30, 2008. Iung B., Baron G., Butchart E.G., Delahaye F., Gohlke- Barwolf C., Levang O.W., et al., A prospective survey of patients with valvular heart disease in Europe: The Euro Heart Survey on Valvular Heart Disease, Eur Heart J, 24, 1231–43, 2003. Khaw A.V., von Bardeleben R.S., Strasser C., Mohr- Kahaly S., Blankenberg S., Espinola-Klein C., et al., Direct measurement of left ventricular outflow tract by transthoracic real-time 3D-echocardiography increases accuracy in assessment of aortic valve stenosis, Int J Cardiol, 136, 64–71, 2009. Kondur A., Pitta S., Afonso L., Incremental utility of real-time three-dimensional echocardiography in the diagnosis and preoperative assessment of cleft mitral valve in adults, Eur J Echocardiogr, 9, 586–8, 2008. Muller S., Muller L., Laufer G., et al., Comparison of three-dimensional imaging to transesophageal echocardiography for preoperative evaluation in mitral valve prolapse, Am J Cardiol, 98, 243–48, 2006. Nichol P.M., Gilbert B.W., Kisslo J.A., Two-dimensional echocardiographic assessment of mitral stenosis. Circulation, 55, 120–8, 1977. Pandian N.G., Roelandt J.R.T.C., Nanda N.C., Sugeng L., Cao Q.L., Azevedo J., et al., Dynamic threedimensional echocardiography: methods and clinical potential, Echocardiogaphy, 11, 237e59, 1994. Pepi M., Tamborini G., Maltagliati A., Galli C.A., Sigillo E., Salvi L., et al., Head-to-head comparison of two- and three-dimensional transthoracic and transesophageal echocardiography in the localization of mitral valve prolapse, J Am Coll Cardiol, 48, 2524–30, 2006. Solis J., Sitges M., Levine R.A., Hung J., Threedimensional echocardiography. New possibilities in mitral valve assessment. Rev Esp Cardiol, 62(2),188-98, 2009. Tamborini G., Muratori M., Maltagliati A., Galli C.A., Naliato M., Zanobini M., 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 J Echocardiogr, 11(9),778-85, 2010. Uno K., Takenaka K., Ebihara A., Nawata K., Hayashi N., Nagasaki M., et al., Value of live 3D transoesophageal echocardiography in the diagnosis of mitral valve lesions, Eur J Echocardiogr, 10, 350–1, 2009. Zamorano J., Cordeiro P., Sugeng L., Perez de Isla L., Weinert L., Macaya C., et al., Real-time threedimensional echocardiography for rheumatic mitral valve stenosis evaluation: an accurate and novel approach, J Am Coll Cardiol, 43(11), 2091-6, 2004. Vahanian A., Baumgartner H., Bax J., Butchart E., Dion R., Filippatos G., et al., Guidelines on the management of valvular heart disease: The Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology, Eur Heart J, 28, 230–68, 2007. Wei J., Hsiung M.C., Tsai S.K., Ou C.H., Chang C.Y., Chang Y.C., et al., The routine use of live threedimensional transesophageal echocardiography in mitral valve surgery: clinical experience, Eur J Echocardiogr, 11, 14–8, 2010. |
*Correspondence: | Cristian Mornos, MD, PhD, Victor Babes University of Medicine and Pharmacy, Timişoara Institute of Cardiovascular Disease, 13 A Gh. Adam st., tel: +40 256207363, fax: +40 256207362, mobile: +40744790381 e-mail: mornoscristi@yahoo.com |