Introduction:
Three-dimensional echocardiography has improved the preoperative evaluation of mitral valve disease. Though, better tools to quantify the amount of prolapsing tissue is warranted. A novel 3D holographic display (Setred AS, Oslo, Norway) offer a 3-dimensional echocardiographic presentation without the need for stereo glasses. We have developed a semi-transparent annulus plane presentation that may better quantitate the prolapsing tissue.
Hypothesis:
We assessed the hypothesis that it is feasible to create a semi-automatic, semi-transparent annulus plane visualized on the holographic display, demonstrating the prolapsed segment that crosses the virtual mitral valve plane.
Methods:
Eight patients with degenerative mitral valve disease were analysed. Three-dimensional transthoracic echocardiography was obtained from an apical view and data was converted to the holographic display for further analysis. Findings were compared with visual inspection during surgery. A semi-automated tool was used to detect the annulus; placement of annulus points was done by clicking out points at small rotation intervals around a rotation center point while rotating around the long axis. After a full rotation, the plane was triangulated using a delaunay triangulation process and the annulus plane was visualized as a semi transparent blue surface. The dataset could then be shown from surgeons view in order to see where the valve crosses the visualized valve plane.
Results:
A total of 48 segments were analysed. We were able to obtain an annulus plane in all and by adding the annulus mitral valve plane, the prolapsing segments could be reproduced in all cases. Figure 1 shows representative recordings (surgeons view) demonstrating a P2 prolapse in the upper panel and a large A2 prolapse in the lower panel.
Conclusion:
In conclusion, the presentation of a semi-transparent annulus plane was feasible and the findings correlated well with that observed during surgery.
Three-dimensional echocardiography in mitral valve disease
