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3d lvot

Abhijeet B Shelke, Rajeev Menon, Anuj Kapadiya, Sachin Yalagudri, Daljeet Saggu, Sandeep Nair, C Narasimhan
OBJECTIVE: Alcohol septal ablation (ASA) is a therapeutic alternative to surgical myectomy in patients with hypertrophic obstructive cardiomyopathy (HOCM). However, the anatomical variability of the septal branch, risk of complete heart block, and late onset ventricular arrhythmias are limitations to its therapeutic usage. There is recent interest in the use of radiofrequency catheter ablation (RFCA) as a therapeutic option in HOCM. We aimed to assess the safety and efficacy of RFCA in the treatment of symptomatic HOCM...
September 2016: Indian Heart Journal
Joshua L Hermsen, Thomas M Burke, Stephen P Seslar, David S Owens, Beth A Ripley, Nahush A Mokadam, Edward D Verrier
OBJECTIVE: Static 3-dimensional printing is used for operative planning in cases that involve difficult anatomy. An interactive 3D print allowing deliberate surgical practice would represent an advance. METHODS: Two patients with hypertrophic cardiomyopathy had 3-dimensional prints constructed preoperatively. Stereolithography files were generated by segmentation of chest computed tomographic scans. Prints were made with hydrogel material, yielding tissue-like models that can be surgically manipulated...
August 20, 2016: Journal of Thoracic and Cardiovascular Surgery
Xiao-Mei Li, He Jiang, Yan-Hui Li, Yan Zhang, Hai-Ju Liu, Hai-Yan Ge, Yi Zhang, Mei-Ting Li
Outflow tract ventricular arrhythmias (OTVAs) are common in children; however, experience is limited on their radiofrequency catheter ablation (RFCA). The purpose of this study was to assess the outcomes of mapping and ablation of pediatric OTVAs and to evaluate the role of ECG algorithms in distinguishing the origin of OTVAs. We compared retrospectively collected single-center data on 92 consecutive pediatric patients (58 male; age, 8.2 ± 2.9 [range 3.6-18] years) who underwent RFCA for OTVAs from 2009 to 2015...
August 26, 2016: Pediatric Cardiology
Cesare Quarto, Simon Davies, Alison Duncan, Alistair Lindsay, Georg Lutter, Lucian Lozonschi, Neil Moat
OBJECTIVE: A small number of transcatheter mitral valve implants (TMVIs) have been reported using devices designed to treat secondary mitral regurgitation (MR). However, MR has many etiologies, and patients have a broad spectrum of annular size, geometry, and lesions. There are a number of technical challenges for TMVI including left ventricular outflow tract obstruction and paravalvular MR. Thirty days' outcome of first-in-man implants with a novel TMVI device is reported. METHODS: The Tendyne TMVI system consists of a porcine pericardial valve in a tethered nitinol frame...
May 2016: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
Mario Montealegre-Gallegos, Robina Matyal, Kamal R Khabbaz, Khurram Owais, Andrew Maslow, Philip Hess, Feroze Mahmood
BACKGROUND: The left ventricular outflow tract (LVOT) is a composite of adjoining structures; therefore, a circular or elliptical shape at one point may not represent its entire structure. The purpose of this study was to evaluate the presence of heterogeneity in the LVOT. METHODS: Patients with normal valvular and ventricular function undergoing elective coronary revascularization surgery were included in the study. Intraoperative R-wave gated 3-dimensional (3D) transesophageal echocardiographic imaging of the LVOT was performed at end-systole, with the midesophageal long axis as the reference view...
August 2016: Anesthesia and Analgesia
Sanjay Dwarakanath, Gyanendra Sharma, Mary E Arthur
OBJECTIVE: Calculations of the left ventricular outflow tract (LVOT) area are typically based on the assumption that the LVOT is circular. This study was conducted to determine whether simultaneous orthogonal plane imaging with tilt during two-dimensional (2D) transesophageal echocardiography provided more accurate measurements of the LVOT area than the standard method. DESIGN: The authors prospectively measured the LVOT area in 2D by (1) the standard calculation based on the diameter as viewed on the long axis, and (2) a direct measurement using planimetry of the short axis, in consecutive patients presenting for elective surgery...
October 2016: Journal of Cardiothoracic and Vascular Anesthesia
W J Zhang, Y L Yang, M X Xie, X F Wang, Q Lyu, L He, J Wang, L Li, J Zhang, Y Wang, J F Liu
OBJECTIVE: To observe image features of sinus of Valsalva aneurysm (SVA) extending into left ventricle by echocardiography. METHODS: Echocardiographic features of 5 cases of SVA extending into left ventricle and underwent surgery at Union Hospital from July 1995 to September 2015 were reviewed retrospectively and image and surgical findings were compared. A total of 4 patients were diagnosed by conventional and 3D echocardiography before surgery, and 1 patient was diagnosed by conventional echocardiography...
June 24, 2016: Zhonghua Xin Xue Guan Bing za Zhi
Karl Crossen, Marsha Jones, Christopher Erikson
BACKGROUND: Alcohol septal ablation remains the only approved nonsurgical therapeutic alternative for patients with drug-resistant hypertrophic obstructive cardiomyopathy (HOCM). Radiofrequency (RF) ablation offers another option for treating HOCM. OBJECTIVE: The purpose of this study was to determine whether irrigated RF ablation can reduce symptomatic outflow tract obstruction in adults with HOCM. METHODS: Patients with symptomatic HOCM and an outflow gradient of >50 mm Hg despite medication were offered RF ablation...
September 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Hiroto Utsunomiya, Hirotsugu Mihara, Yuji Itabashi, Sayuki Kobayashi, Robert J Siegel, Tarun Chakravarty, Hasan Jilaihawi, Raj R Makkar, Takahiro Shiota
AIMS: Prosthesis-patient mismatch (PPM) after transcatheter aortic valve replacement (TAVR) leads to increased mortality. However, its peri-procedural determinants remain unknown. We investigated geometric changes in aortic annulus (AoA) and left ventricular outflow tract (LVOT) during TAVR by three-dimensional transoesophageal echocardiography (3D-TEE) and its association with post-procedural PPM. METHODS AND RESULTS: A total of 131 patients with severe aortic stenosis underwent intraprocedural 3D-TEE during balloon-expandable TAVR...
March 29, 2016: European Heart Journal Cardiovascular Imaging
Sandro Queiros, Alexandros Papachristidis, Daniel Barbosa, Konstantinos C Theodoropoulos, Jaime C Fonseca, Mark J Monaghan, Joao L Vilaca, Jan D'hooge
A novel semi-automatic algorithm for aortic valve (AV) wall segmentation is presented for 3D transesophageal echocardiography (TEE) datasets. The proposed methodology uses a 3D cylindrical formulation of the B-spline Explicit Active Surfaces (BEAS) framework in a dual-stage energy evolution process, comprising a threshold-based and a localized regionbased stage. Hereto, intensity and shape-based features are combined to accurately delineate the AV wall from the ascending aorta (AA) to the left ventricular outflow tract (LVOT)...
March 18, 2016: IEEE Transactions on Medical Imaging
Oholi Tovia-Brodie, Yoav Michowitz, Aharon Glick, Raphael Rosso, Bernard Belhassen
BACKGROUND: Left ventricular outflow tract (LVOT) arrhythmias are increasingly recognized. Data regarding the distribution of the sites of origin (SOO) of the arrhythmias are sparse. OBJECTIVES: To describe the clinical characteristics of patients with LVOT arrhythmias and the distribution of their SOO. METHODS: All 42 consecutive patients with LVOT arrhythmias who underwent radiofrequency (RF) ablation during the period 2000-2014 were included...
February 2016: Israel Medical Association Journal: IMAJ
Guy L J Vermeiren, Manu L N G Malbrain, Jeroen M J B Walpot
Cardiac ultrasonography has become an indispensible tool in the management of hemodynamically unstable critically ill patients. Some consider it as the modern stethoscope. Echocardiography is non-invasive and safe while the modern portable devices allow to be used at the bedside in order to provide fast, specific and vital information regarding the hemodynamic status, as well as the function, structure and anatomy of the heart. In this review, we will give an overview of cardiac function in general followed by an assessment of left ventricular function using echocardiography with calculation of cardiac output, left ventricular ejection fraction (EF), fractional shortening, fractional area contraction, M mode EF, 2D planimetry and 3D volumetry...
2015: Anaesthesiology Intensive Therapy
Tae-Yun Sung, Won-Kyoung Kwon, Dong-Ho Park, Cheol-Hwan Park, Tae-Yop Kim
Intraoperative three-dimensional (3D) transesophageal echocardiography (TEE) facilitates an understanding of the complex cardiac pathology that is not fully delineated in a two-dimensional (2D) echocardiographic evaluation, and it suggests earlier and more precise surgical planning and intraoperative decision making. In the present case, the intraoperative 2D-TEE midesophageal long-axis view indicated a significant narrowing of the left ventricular outflow tract (LVOT) area by a band-like structure that vertically traversed the middle of the LVOT and connected to the anterior mitral leaflet base and the interventricular septum...
October 2015: Korean Journal of Anesthesiology
Pim van Ooij, Bradley D Allen, Carla Contaldi, Julio Garcia, Jeremy Collins, James Carr, Lubna Choudhury, Robert O Bonow, Alex J Barker, Michael Markl
PURPOSE: Hypertrophic cardiomyopathy (HCM) is associated with altered hemodynamics in the left ventricular outflow tract (LVOT) and myocardial tissue abnormalities such as fibrosis. The aim of this study was to quantify changes in LVOT 3D hemodynamics and myocardial extracellular volume fraction (ECV, measure of fibrosis) and to investigate relationships between elevated flow metrics and left ventricular (LV) tissue abnormalities. MATERIALS AND METHODS: Cardiac magnetic resonance imaging (MRI) including 4D flow (field strength = 1...
January 2016: Journal of Magnetic Resonance Imaging: JMRI
Micha T Maeder, Sofie Karapanagiotidis, Elizabeth M Dewar, David M Kaye
INTRODUCTION: We aimed to determine the accuracy of the echocardiographic assessment of cardiac index (CI) in subjects with preserved left ventricular ejection fraction (LVEF). METHODS: Thirty-three subjects with LVEF >50%, normal sinus rhythm, and a broad spectrum of hemodynamic profiles underwent echocardiography immediately followed by right heart catheterization. As gold standards, CI was assessed using thermodilution [CI (TD)] and the Fick method [CI (F)]...
November 2015: Echocardiography
Eriko Shimada, Meihua Zhu, Sumito Kimura, Cole Streiff, Helene Houle, Saurabh Datta, David J Sahn, Muhammad Ashraf
OBJECTIVES: Noninvasive quantification of left ventricular (LV) stroke volumes has an important clinical role in assessing circulation and monitoring therapeutic interventions for cardiac disease. This study validated the accuracy of a real-time 3-dimensional (3D) color flow Doppler method performed during transthoracic echocardiography (TTE) for quantifying volume flows through the mitral and aortic valves using a dedicated offline 3D flow computation program compared to LV sonomicrometry in an open-chest animal model...
January 2015: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
Joshua K Y Swee, Saša Grbić
Transcatheter aortic valve implantation (TAVI) is becoming a standard treatment for non-operable and high-risk patients with symptomatic severe aortic valve stenosis. As there is no direct view or access to the affected anatomy, comprehensive preoperative planning is crucial for a successful outcome, with the most important decisions made during planning being the selection of the proper implant size, and determining the correct C-arm angulations. While geometric models extracted from 3D images are often used to derive these measurements, the complex shape variation of the AV anatomy found in these patients causes many of the shape representations used to estimate such geometric models to fail in capturing morphological characteristics in sufficient detail...
2014: Medical Image Computing and Computer-assisted Intervention: MICCAI ..
Kenneth A Fetterly, Verghese Mathew
During transcatheter aortic valve replacement procedures, alignment of the interventional x-ray beam with the aortic valve plane is required to guide valve placement. The purpose of this work was to develop methods to measure x-ray beam angles which are aligned with the aortic valve plane from a single x-ray image of a valvuloplasty balloon inflated across the left ventricular outflow tract (LVOT). A custom valvuloplasty balloon and image analytics were developed. In-vivo pig experiments demonstrated that the angular orientation of the LVOT can be measured with precision less than 3°, including the influence of cardiac motion during rapid pacing...
February 2015: Journal of Medical Engineering & Technology
Hyemoon Chung, Ji Hyun Yoon, Young Won Yoon, Ji Young Chung, Jung-Joon Cha, Jong-Youn Kim, Pil-Ki Min, Byoung-Kwon Lee, Bum-Kee Hong, Se-Joong Rim, Hyuck Moon Kwon, Eui-Young Choi
BACKGROUND: The three-dimensional (3D) dynamic change of mitral geometry during preload manipulation has not been fully investigated. We investigated how preload manipulation affected the mitral apparatus geometry in hypertrophic cardiomyopathy (HCM) patients using 3D echocardiography. METHODS AND RESULTS: Twenty five HCM patients, thirteen with obstructive HCM (HOCM) and twelve with nonobstructive HCM (HNCM), and six healthy controls were studied. Subjects underwent 3D echocardiography during rest, leg raising, the Valsalva maneuver, and the Valsalva maneuver after nitroglycerin intake (NTG-Valsalva)...
August 2015: Echocardiography
Christopher Howell Critoph, Antonios Pantazis, Maria Teresa Tome Esteban, Joel Salazar-Mendiguchía, Efstathios D Pagourelias, James C Moon, Perry Mark Elliott
OBJECTIVES: Aortoseptal angulation (AoSA) can predict provocable left ventricular outflow tract obstruction (LVOTO) in patients with symptomatic hypertrophic cardiomyopathy (HCM). Lack of a standardised measurement technique in HCM without the need for complex three-dimensional (3D) imaging limits its usefulness in routine clinical practice. This study aimed to validate a simple measurement of AoSA using 2D echocardiography and cardiac MR (CMR) imaging as a predictor of LVOTO. METHODS: We retrospectively assessed 160 patients with non-obstructive HCM, referred for exercise stress echocardiography...
2014: Open Heart
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