scholarly journals The impact of intraoperative pericardial three-dimensional echocardiography for the atrioventricular valve repair in the patient with congenital heart disease

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
R Numata ◽  
K Takigiku ◽  
K Takei ◽  
Y Akazawa ◽  
K Yonehara ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Surgical Outcome ◽  
Congenital Heart ◽  
Three Dimensional ◽  
Successful Outcome ◽  
Atrioventricular Valve ◽  
Dimensional Echocardiography ◽  
Three Dimensional Echocardiography ◽  
The Impact

Abstract Background Atrioventricular valve (AVV) regurgitation enormously affected the survival outcome of the patients with congenital heart disease (CHD). However, the image quality by use of transthoracic echocardiography has not reached a level that is sufficient, and also, three-dimensional echocardiography, which is useful to clarify complex AVV anatomy, cannot be applied for the patients less than 15kg, to guide for the AVV repair in pediatric patients. We try to show surgeons more precise three-dimensional images about an AVV by using intraoperative pericardial three-dimensional echocardiography (IP3DE) and improve the surgical outcome. Purpose To determine the efficacy of IP3DE by assessing the surgical outcome of an AVV repair and re-intervention rate. Method Eighty-five patient with CHD who underwent atrioventricular repair with significant regurgitation (Grade 2–4+) before operation were divided into two groups imaged IP3DE or not, in our hospital from 1993 to 2020. We assessed the surgical outcome and re-intervention rate between two arms and re-evaluate AVV images before surgery compared to the IP3DE. Result IP3DE was performed in forty-six patients (IP3DE group) and thirty-nine patients were not (control group). Median age at AVV repair was 3.0/2.8 years, respectively. The AVV was tricuspid (n=25), mitral (n=41), or common (n=19). The IP3DE group had a significantly higher improvement in regurgitation of AVV (IP3DE: Grade 3.2±0.3 → 1.7±0.3 vs Control: Grade 2.8±0.3 → 1.8±0.3, p<0.05). Fifty-nine percent of the IP3DE group was successful outcome (Grade<1+ after repair). There was no significant difference in the rate of re-intervention after surgery between two groups. In multivariate analysis, using IP3DE contributed to successful outcome for AVV repair (OR: 4.66, 95% CI: 1.46–14.8, p<0.01). The different and/or additional anatomical AVV findings were obtained in sixty-one percent of patients by the IP3DE. Conclusion IP3DE contributes to successful outcome for AVV repair by obtaining further information on complicated AVV anatomy in congenital heart disease. IP3DE also enables both cardiovascular surgeons and cardiologists to share the accurate and detail “surgeon's view” in the operating room for planning of AVV repair. FUNDunding Acknowledgement Type of funding sources: None.

Abstract 2340: Should Real-time Three-dimensional Echocardiography Become The Preoperative Standard For The Evaluation Of The Mechanisms Of Atrioventricular Valve Regurgitation In The Patient With Congenital Heart Disease?

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Ken Takahashi ◽  
Akio Inage ◽  
Murray Robertson ◽  
Dyck John ◽  
Ross David ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Real Time ◽  
Congenital Heart ◽  
Three Dimensional ◽  
Atrioventricular Valve ◽  
Valve Regurgitation ◽  
Structural Abnormalities ◽  
Dimensional Echocardiography ◽  
Three Dimensional Echocardiography

Objective: The purpose of this study was to determine whether Real-time three-dimensional echocardiography (RT3D) is superior to two-dimensional echocardiography (2D) in determining mechanisms and site(s) of atrioventricular valve (AV valve) regurgitation in congenital heart disease. Background: Data is lacking on the utility of RT3D echo in congenital abnormalities of the AV valves. Methods: Between May 2006 and April 2007, 35 cases were prospectively studied prior to AV valve repair (20 left and 15 right) by 2D transthoracic (2DTTE), 2D transesophageal (2DTEE) and RT3D (Philips matrix array X 3–1 and X 7–2). Thirty one had significant and 4 mild regurgitation. Ages ranged from 24 days to 30 years (mean 13.8 years), weight 2.2 to 42kg (mean 26.1Kg). The 2DTTE and TEE were reviewed by a blinded observer. The 3D data were analyzed by a separate observer. In 28 patients surgical findings and regurgitation from saline testing were recorded by digital video and later analyzed by an experienced cardiac surgeon. The remaining 7 had a detailed description of the valve morphology documented immediately after surgery. Surgical findings were used as the gold standard for the assessment of structural abnormalities, with RT3D for the evaluation of regurgitation. Results: See table for structural abnormalities. For both the left and right AV valve, saline testing provided a poorer correlation with RT3D color Doppler jet location, in particular for regurgitant jets from the commmissures (p < 0.01). Conclusion: Transthoracic RT3D provides new and superior information as to the mechanisms and site(s) of AV valve failure in congenital heart disease. Concordance between 2D TTE, 2D TEE and 3D TTE compared to surgical findings

Feasibility and Clinical Impact of Live Three-Dimensional Echocardiography in the Management of Congenital Heart Disease

2006 ◽  
Vol 23 (7) ◽  
pp. 553-561 ◽  
Author(s):  
Stefano De Castro ◽  
Stefano Caselli ◽  
Federica Papetti ◽  
Flavia Ventriglia ◽  
Arianna Giardina ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Three Dimensional ◽  
Clinical Impact ◽  
Dimensional Echocardiography ◽  
Three Dimensional Echocardiography

scholarly journals A Virtual Reality System for Improved Image-based Planning of Complex Cardiac Procedures

2021 ◽  
Author(s):  
Shujie Deng ◽  
Gavin Wheeler ◽  
Nicolas Toussaint ◽  
Lindsay Munroe ◽  
Suryava Bhattacharya ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Virtual Reality ◽  
Heart Disease ◽  
Congenital Heart ◽  
Three Dimensional ◽  
Patient Specific ◽  
Two Dimensional ◽  
Virtual Reality System ◽  
Dimensional Echocardiography ◽  
Three Dimensional Echocardiography

The intricate nature of congenital heart disease requires understanding of complex, patient-specific three-dimensional dynamic anatomy of the heart, from imaging data such as three-dimensional echocardiography for successful outcomes from surgical and interventional procedures. Conventional clinical systems use flat screens and therefore display remains two-dimensional, which undermines the full understanding of the three-dimensional dynamic data. Additionally, control of three-dimensional visualisation with two-dimensional tools is often difficult, so used only by imaging specialists. In this paper we describe a virtual reality system for immersive surgery planning using dynamic three-dimensional echocardiography, which enables fast prototyping for visualisation such as volume rendering, multi-planar reformatting, flow visualisation, and advanced interaction such as three-dimensional cropping, windowing, measurement, haptic feedback, automatic image orientation, and multi-user interactions. The available features were evaluated by imaging and non-imaging clinicians, showing that the virtual reality system can help improve understanding and communication of the three-dimensional echocardiography imaging and potentially benefit congenital heart disease treatment.

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