scholarly journals The Most Accurate and Fastest Method for Measurement of Vena Contracta Area by Direct Planimetry 3D Transesophageal Echocardiography

2018 ◽  
Vol 6 (3) ◽  
pp. 29
Author(s):  
Mehrnoush Toufan ◽  
Dina Ashouri
Keyword(s):  
Clinical Practice ◽  
Mitral Regurgitation ◽  
Three Dimensional ◽  
Two Dimensional ◽  
Vena Contracta ◽  
2D Echocardiography ◽  
3D Transesophageal Echocardiography ◽  
Integrative Method ◽  
Vena Contracta Area ◽  
Reliable Methods

Dear Editor, Two-dimensional (2D) echocardiography is a powerful tool for assessment of mitral regurgitation (MR) [1]. However, it bears several major disadvantages. Evidence suggests that measurement of the vena contracta area (VCA) via a three-dimensional (3D) method is significantly more accurate than 2D methods in the quantification of MR since the 2D method is not sufficiently reliable in calculation of VC diameter because of  circular assumption of VC area [2]. VCA direct planimetry (DP) and multiplanar reconstruction (MPR)-derived VCA are direct and reliable methods to quantify MR severity, and their results are comparable with those of 2D integrative method [2, 3]. It is strongly recommended that these methods especially DP can replace 2D methods in the quantification of MR in the clinical practice, as it is more accurate and easy to perform [3].

scholarly journals Three-Dimensional Color Doppler Echocardiography for Direct Measurement of Vena Contracta Area in Mitral Regurgitation

2008 ◽  
Vol 1 (6) ◽  
pp. 695-704 ◽  
Author(s):  
Stephen H. Little ◽  
Bahar Pirat ◽  
Rahul Kumar ◽  
Stephen R. Igo ◽  
Marti McCulloch ◽  
...  
Keyword(s):  
Mitral Regurgitation ◽  
Direct Measurement ◽  
Doppler Echocardiography ◽  
Color Doppler ◽  
Three Dimensional ◽  
Color Doppler Echocardiography ◽  
Vena Contracta ◽  
Vena Contracta Area

scholarly journals Prognostic value of three dimensional-vena contracta area in patients with secondary mitral regurgitation

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
I Yedidya ◽  
V Mantegazza ◽  
F Namazi ◽  
R Lustosa ◽  
S C Butcher ◽  
...  
Keyword(s):  
Heart Failure ◽  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Color Doppler ◽  
Three Dimensional ◽  
Heart Failure Hospitalization ◽  
Vena Contracta ◽  
All Cause Mortality ◽  
3D Color Doppler ◽  
Vena Contracta Area

Abstract Background Effective regurgitant orifice area (EROA) is an important quantitative measurement for mitral regurgitation (MR) grading. Yet, the accuracy of this method is limited in patients with secondary mitral regurgitation (SMR). Three-dimensional (3D) color Doppler echocardiography allows for the direct assessment of the vena contracta area (VCA). The prognostic value of 3D-VCA in patients with secondary MR has not been investigated. Purpose The aim of the present study was to assess the association between 3D-VCA and prognosis of patients with SMR. Methods A total of 218 patients (69% men, median age 74 years) with significant SMR were retrospectively analyzed. 3D-VCA was measured offline with dedicated software, from restored 3D color Doppler full volume datasets of the mitral valve (Figure 1). The population was divided according to the American College of Cardiology expert recommendation for the grading of severe MR (VCA ≥50 mm2 and VCA <50 mm2). Patients were followed up for the combined end point of all-cause mortality or heart failure hospitalization. Results Of the total population, 63% had an ischemic etiology, 60% had atrial fibrillation and 25% cardiac resynchronization therapy. Patients with 3D-VCA ≥50 mm2 needed more diuretic therapy, had a larger left ventricle and atrium, and had more post-procedural residual MR. A total of 82% of patients underwent MitraClip device implantation, 17% had mitral valve repair and 1% had mitral valve replacement. During a median follow-up of 28 months, 130 (60%) met the combined end point (101 (46%) patients died and 81 (37%) were hospitalized due to heart failure). When dividing the population according to the cut-off of 3D-VCA, patients with a 3D-VCA≥50 mm2 had a worse prognosis compared with their counterparts (Figure 2). In a multivariable Cox regression analysis, 3D-VCA≥50 mm2 remained independently associated with the composite endpoint of all-cause mortality or heart failure hospitalization (HR=1.454, 95% CI 1.020–2.072, p=0.038). Conclusion In patients with SMR, a 3D-VCA ≥50 mm2 was independently associated with a combined endpoint of death or heart failure hospitalization. FUNDunding Acknowledgement Type of funding sources: None. Figure 1. Method of 3D-VCA measurement Figure 2. Kaplan-Meier survival curve

Quantification of Mitral Regurgitation by Live Three-Dimensional Transthoracic Echocardiographic Measurements of Vena Contracta Area

2004 ◽  
Vol 21 (8) ◽  
pp. 737-743 ◽  
Author(s):  
Deepak Khanna ◽  
Srinivas Vengala ◽  
Andrew P. Miller ◽  
Navin C. Nanda ◽  
Steven G. Lloyd ◽  
...  
Keyword(s):  
Mitral Regurgitation ◽  
Three Dimensional ◽  
Vena Contracta ◽  
Vena Contracta Area

Quantification of Tricuspid Regurgitation by Live Three-Dimensional Transthoracic Echocardiographic Measurements of Vena Contracta Area

2006 ◽  
Vol 23 (9) ◽  
pp. 793-800 ◽  
Author(s):  
Dasan E. Velayudhan ◽  
Todd M. Brown ◽  
Navin C. Nanda ◽  
Vinod Patel ◽  
Andrew P. Miller ◽  
...  
Keyword(s):  
Tricuspid Regurgitation ◽  
Three Dimensional ◽  
Vena Contracta ◽  
Vena Contracta Area

Abstract 15817: Tricuspid Valve Imaging by 3D Transesophageal Echocardiography: Feasibility of Coaptation Length Measurement and Its Relationship With Severity of Regurgitation

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Kikuko Obase ◽  
Lynn Weinert ◽  
Victor Mor-Avi ◽  
Roberto M Lang
Keyword(s):  
Transesophageal Echocardiography ◽  
Tricuspid Valve ◽  
Tricuspid Regurgitation ◽  
Three Dimensional ◽  
The Other ◽  
Tricuspid Valve Repair ◽  
Mitral Valve Leaflet ◽  
2D Echocardiography ◽  
3D Transesophageal Echocardiography ◽  
Leaflet Coaptation

Background: The coaptation length (CL) of the mitral valve leaflet decreases with increasing mitral regurgitation. Visualization of the CL of the tricuspid valve (TV) is challenging using conventional 2D echocardiography. The aims of this study were: (1) to test the feasibility of visualizing and quantifying the CL of the TV using three-dimensional (3D) transesophageal echocardiography (TEE), and (2) to study it relationship with the severity of tricuspid regurgitation (TR). Methods: Full-volume 3D TEE datasets of the TV were obtained in 24 patients from the transgastric approach. Using multiplanar reconstruction, short-axis plane depicting an en-face view of the TV was used to mark the central coaptation point (Fig. A). Three planes cutting through this point were then selected to view the 3 coaptation lines between: (1) anterior and posterior, (2) septal and anterior, and (3) septal and posterior TV leaflets (Figs. B-D). The CL was measured in each of these planes to obtain mean CL. The severity of tricuspid regurgitation was graded qualitatively as “none”, “trace”, “mild” and “moderate”. Results: Visualization of leaflet coaptation was feasible in 17/24 patients (71%). The mean CL was 0.89±0.03 cm in patients with no TR (N=4), 0.64±0.13 with trace TR (N=6), 0.50±0.07 with mild TR (N=3) and 0.13±0.11 with moderate TR (N=4). Since there was no overlap between the “moderate” group and the other 3 groups, the threshold of average CL for moderate TR was estimated to be between 0.25 (highest value in the “moderate” group) and 0.39 cm (lowest value in the other groups) (Fig. E). Conclusion: Visualization of the TV leaflet coaptation length from transgastric 3D TEE images is feasible in the majority of patients. TV coaptation length is inversely related to the severity of TR. The ability to visualize and quantify the CL of the TV may be useful when planning tricuspid valve repair surgery. Our findings suggest that CL below the threshold may indicate clinically significant TR.

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