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3d lvot

Frédéric Maes, Sophie Pierard, Christophe de Meester, Jamila Boulif, Mihaela Amzulescu, David Vancraeynest, Anne-Catherine Pouleur, Agnès Pasquet, Bernhard Gerber, Jean-Louis Vanoverschelde
BACKGROUND: The pathophysiology of paradoxical low-gradient (LG) severe aortic stenosis (SAS) remains controversial. As low transvalvular flow has been implicated, we sought to investigate the impact of left ventricular outflow tract (LVOT) ellipticity on the estimation of the LV stroke volume, the calculation of the aortic valve area (AVA) by use of the continuity equation and on AS severity grading. METHODS: We studied 190 consecutive patients (mean age: 72 ± 13 years; male: 57%) with SAS (indexed AVA < 0...
March 15, 2017: Journal of Cardiovascular Magnetic Resonance
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
Sandro Queiros, Alexandros Papachristidis, Pedro Morais, Konstantinos C Theodoropoulos, Jaime C Fonseca, Mark J Monaghan, Joao L Vilaca, Jan D'hooge
A novel fully automatic framework for aortic valve (AV) trunk segmentation in 3D transesophageal echocardiography (TEE) datasets is proposed. The methodology combines a previously presented semi-automatic segmentation strategy using shape-based B-spline Explicit Active Surfaces with two novel algorithms to automate the quantification of relevant AV measures. The first combines a fast rotation-invariant 3D Generalized Hough Transform with a vessel-like dark tube detector to initialize the segmentation. After segmenting the AV wall, the second algorithm focuses on aligning this surface with reference ones in order to estimate the short-axis (SAx) planes (at the left ventricular outflow tract, annulus, sinuses of Valsalva and sinotubular junction) in which to perform the measurements...
October 13, 2016: IEEE Transactions on Bio-medical Engineering
Sergiu Darabant, Shelby B Oberton, Luis P Roldan, Carlos A Roldan
Aortic valve infective endocarditis (IE) can be complicated with severe aortic regurgitation (AR) jet-related lesions such as vegetations, pseudoaneurysms, aneurysms or perforations on the anterior mitral leaflet. Herein is reported the case of a 69-year-old male with culture-negative aortic valve endocarditis complicated with aortic valve perforations resulting in severe and eccentric AR and an AR jet-related ventricular septal defect (VSD). Neither transthoracic echocardiography (TTE) nor two-dimensional transesophageal echocardiography (2D-TEE) were unable to clearly discriminate an aorto-right ventricular fistula from a VSD...
March 2016: Journal of Heart Valve Disease
Kenneth Fetterly, Kevin Greason, Verghese Mathew
OBJECTIVES: The purpose of this work is to describe methods to measure the 3D angular orientation of cardiovascular structures based on a planar image of a valvuloplasty balloon. These methods facilitate X-ray beam alignment with respect to the anatomy of interest. BACKGROUND: X-ray beam projections which are perpendicular to the long axis of cardiovascular structures are required to support interventional procedures, including transcatheter aortic valve implant (TAVI)...
November 29, 2016: Catheterization and Cardiovascular Interventions
Luis Caballero, Daniel Saura, María José Oliva-Sandoval, Josefa González-Carrillo, María Dolores Espinosa, Miguel García-Navarro, Mariano Valdés, Patrizio Lancellotti, Gonzalo de la Morena
BACKGROUND: Left ventricular outflow tract (LVOT) measurement is a critical step in the quantification of aortic valve area. The assumption of a circular morphology of the LVOT may induce some errors. The aim of this study was to assess the three-dimensional (3D) morphology of the LVOT and its impact on grading aortic stenosis severity. METHODS: Fifty-eight patients with aortic stenosis were studied retrospectively. LVOT dimensions were measured using 3D transesophageal echocardiography at three levels: at the hinge points (HP) of the aortic valve and at 4 and 8 mm proximal to the annular plane...
January 2017: Journal of the American Society of Echocardiography
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...
January 2017: 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...
December 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...
January 2017: 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 region-based 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)...
September 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
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