Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography
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J Am Soc Echocardiogr · Jun 2011
ReviewImaging the atrial septum using real-time three-dimensional transesophageal echocardiography: technical tips, normal anatomy, and its role in transseptal puncture.
Extraordinary advances in technology have made possible percutaneous catheter-based treatment of a wide spectrum of specific pediatric and adult "structural" heart diseases. Many of these percutaneous interventional procedures require access to the left heart via transseptal catheterization. Being able to see the anatomy can be a considerable advantage. ⋯ Because of lack of interference from bone and lung and the closer proximity of the transducer to the posterior structures of the heart, this technique provides 3D RT images of atrial structures of unprecedented quality. In this review, the authors describe two key areas: a step-by-step approach for acquiring and processing RT 3D transesophageal echocardiographic images of the interatrial septum and, second, septal anatomy as it is visualized by RT 3D transesophageal echocardiography. To demonstrate their consistency with actual anatomy, several RT 3D transesophageal echocardiographic images are matched to equivalent anatomic specimens.
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J Am Soc Echocardiogr · Jun 2011
Left atrial volume by real-time three-dimensional echocardiography: validation by 64-slice multidetector computed tomography.
Left atrial (LA) enlargement has been acknowledged as a significant predictor of cardiovascular morbidity and mortality. ⋯ LA volume assessment by three-dimensional echocardiography was correlated closely with that measured by MDCT, albeit with an 8% underestimation. Three-dimensional echocardiography is a feasible noninvasive method to evaluate LA volume.
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J Am Soc Echocardiogr · Jun 2011
Left atrial systolic and diastolic dysfunction in heart failure with normal left ventricular ejection fraction.
The authors hypothesized that in patients with heart failure with normal left ventricular (LV) ejection fraction (HFNEF), the same fibrotic processes that affect the subendocardial layer of the left ventricle could also alter the subendocardial fibers of the left atrium. Consequently, these fibrotic alterations, together with chronically elevated LV filling pressures, would lead to both systolic and diastolic subendocardial dysfunction of the left atrium (i.e., impaired left atrial [LA] longitudinal systolic and diastolic function) in patients with HFNEF. ⋯ In patients with HFNEF, LA subendocardial systolic and diastolic dysfunction is common and possibly associated with the same fibrotic processes that affect the subendocardial fibers of the left ventricle and to a lesser extent with elevated LV filling pressures. Furthermore, these findings suggest that LA longitudinal systolic and diastolic dysfunction could be related to reduced functional capacity during effort in patients with HFNEF.
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J Am Soc Echocardiogr · Jun 2011
Case ReportsLeft atrial myxomas: correlation of two-dimensional and live three-dimensional transesophageal echocardiography with the clinical and pathologic findings.
Although transthoracic echocardiography and two-dimensional transesophageal echocardiography (TEE) identify cardiac myxomas with high sensitivity, anatomic and morphologic information is often incomplete. Real-time three-dimensional (3D) TEE is increasingly being used in general clinical practice. However, the use of real-time 3D TEE for the assessment of atrial myxomas has not been described. ⋯ Because the 3D TEE is real time and can be performed preoperatively in the operating room, the surgeon may gain a better understanding of the nature and location of the tumor.
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J Am Soc Echocardiogr · Jun 2011
Case ReportsComplications of percutaneous edge-to-edge mitral valve repair: the role of real-time three-dimensional transesophageal echocardiography.
Percutaneous edge-to-edge mitral valve repair can be performed safely, and reductions in mitral regurgitation can be achieved in a significant proportion of patients. However, complications can arise in a minority of patients. The authors report three cases in which complications of percutaneous mitral valve repair were documented by real-time three-dimensional transesophageal echocardiography. This new imaging technique provides real-time, easily understandable images of valve anatomy and the percutaneous mitral valve repair procedure, which helps guide the decision-making process.