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3d lvot

Enrico Ferrari, Luigi Biasco, Francesco Faletra, Anson Cheung, Marco Moccetti, Giovanni Pedrazzini, Stefanos Demertzis, Tiziano Moccetti
Transcatheter mitral valve replacement with the TiaraTM valve can be performed in inoperable patients with severe functional regurgitation. Risk of left ventricular outflow tract obstruction can be prevented using preoperative 3D-imaging and 3D-printed models. However, in case of mono-disk mechanical prosthesis previously implanted in aortic position (Bjork-Shiley) there is an additional risk of mechanical interference leading to reduced leaflet motion and aortic valve dysfunction. Hereafter, we describe the case of a patient with a 27mm mono-disk mechanical aortic valve implanted in 1978, Euroscore-II of 18% and STS-score (mortality) of 16% who successfully underwent a transapical TiaraTM valve implantation...
March 5, 2018: Seminars in Thoracic and Cardiovascular Surgery
Long Deng, Xueying Huang, Chun Yang, Yunhu Song, Dalin Tang
Left ventricular outflow tract obstruction is observed in 70% of patients with hypertrophic cardiomyopathy, which occurs in about 1 of every 500 adults in the general population. It has been widely believed that the motion of the mitral valve, in particular, its systolic anterior motion (SAM), attributes significantly to such obstruction. For a better understanding of the mitral valve motion, a 3D patient-specific fluid-structure interaction model of the left ventricle from a patient with hypertrophic obstructive cardiomyopathy based on computed tomography (CT) scan images was proposed in this study...
February 21, 2018: Computer Methods in Biomechanics and Biomedical Engineering
Mustafa Erden, Hannah G van Velzen, Myrthe E Menting, Annemien E van den Bosch, Ben Ren, Michelle Michels, Wim B Vletter, Ron T van Domburg, Arend F L Schinkel
BACKGROUND: Hypertrophic cardiomyopathy (HC) is characterized by left ventricular (LV) hypertrophy and associated with papillary muscle (PM) abnormalities. The aim of this study was to evaluate the utility of three-dimensional echocardiography (3DE) for the geometric assessment of LV hypertrophy and PM morphology. METHODS: The study included 24 patients with an established diagnosis of HC and 31 healthy controls. 3DE was performed using an iE33 or EPIQ 7C ultrasound system with an X5-1 transducer...
January 6, 2018: Journal of Ultrasound
Abdallah El Sabbagh, Mackram F Eleid, Jane M Matsumoto, Nandan S Anavekar, Mohammed A Al-Hijji, Sameh M Said, Vuyisile T Nkomo, David R Holmes, Charanjit S Rihal, Thomas A Foley
INTRODUCTION: Three-dimensional (3D) prototyping is a novel technology which can be used to plan and guide complex procedures such as transcatheter mitral valve replacement (TMVR). METHODS: Eight patients with severe mitral annular calcification (MAC) underwent TMVR. 3D digital models with digital balloon expandable valves were created from pre-procedure CT scans using dedicated software. Five models were printed. These models were used to assess prosthesis sizing, anchoring, expansion, paravalvular gaps, left ventricular outflow tract (LVOT) obstruction, and other potential procedure pitfalls...
January 23, 2018: Catheterization and Cardiovascular Interventions
Karin Graeser, Mikhail Zemtsovski, Klaus F Kofoed, Matilde Winther-Jensen, Jens C Nilsson, Jesper Kjaergaard, Hasse Møller-Sørensen
BACKGROUND: Estimation of cardiac output (CO) is essential in the treatment of circulatory unstable patients. CO measured by pulmonary artery catheter thermodilution is considered the gold standard but carries a small risk of severe complications. Stroke volume and CO can be measured by transesophageal echocardiography (TEE), which is widely used during cardiac surgery. We hypothesized that Doppler-derived CO by 3-dimensional (3D) TEE would agree well with CO measured with pulmonary artery catheter thermodilution as a reference method based on accurate measurements of the cross-sectional area of the left ventricular outflow tract...
January 9, 2018: Anesthesia and Analgesia
Giovanni Barbati, Roberto Zeppellini, Giovanna Erente, Angelo B Ramondo
Transcatheter aortic valve implantation (TAVI) has revolutionized the treatment of elderly patients with symptomatic severe aortic valve stenosis. Among the possible TAVI complications, a rare one is the annular/left ventricular outflow tract rupture. We report a rare case of a late complex ventricular septal defect (VSD) following TAVI with a balloon-expandable prosthesis, conservatively managed. Our case demonstrates the role of 3D transthoracic echocardiography (3DTTE) in the accurate diagnosis of this TAVI complication and suggests that, in some cases, it can be used as an alternative to other diagnostic tools, such as transesophageal echocardiography, cardiac catheterization, and computed tomography...
December 17, 2017: Echocardiography
Yunsun Song, Dong Hyun Yang, Bríain Ó Hartaigh, Se Jin Cho, Joon-Won Kang, Young-Hak Kim, Joon Bum Kim, Dae-Hee Kim, Jong-Min Song, Duk-Hyun Kang, Jae-Kwan Song, Tae-Hwan Lim
Aims: To establish geometric predictors of left ventricular outflow tract obstruction (LVOTO) in hypertrophic cardiomyopathy (HCM) patients by use of cardiac computed tomography (CT). Methods and results: A total of 141 consecutive patients with HCM who underwent cardiac CT comprised the analytic sample. The degree, pattern, and extent of left ventricular (LV) hypertrophy were evaluated using 3D CT. Abnormality of papillary muscle (PM), mitral valve, and aorto-mitral angle were evaluated quantitatively...
October 11, 2017: European Heart Journal Cardiovascular Imaging
Bartosz Ludwik, Karol Deutsch, Mariusz Mazij, Janusz Śledź, Aleksandra Morka, Michał Labus, Michał Chrabąszcz, Bartosz Szafran, Jerzy Śpikowski, Lesław Szydłowski, Sebastian M Stec
INTRODUCTION    The current guidelines of the European Society of Cardiology outlined electrocardiographic (ECG) differentiation of the site of origin (SoO) in patients with idiopathic ventricular arrhythmias (IVAs). OBJECTIVES    The aim of this study was to compare 3 ECG algorithms for differentiating the SoO and to determine their diagnostic value for the management of outflow tract IVA. PATIENTS AND METHODS    We analyzed 202 patients (mean age [SD]: 45 [16.7] years; 133 women [66%]) with IVAs with the inferior axis (130 premature ventricular contractions or ventricular tachycardias from the right ventricular outflow tract [RVOT]; 72, from the left ventricular outflow tract [LVOT]), who underwent successful radiofrequency catheter ablation (RFCA) using the 3‑dimensional electroanatomical system...
November 30, 2017: Polish Archives of Internal Medicine
Edwin Wilberforce Turton, Jörg Ender
PURPOSE OF REVIEW: This review aims to highlight the general and specific strengths and limitations of intraoperative 3D echocardiography. This article explains the value of real-time three-dimensional transesophageal echocardiography (RT 3D TEE) during cardiac surgery and cardiac interventions. RECENT FINDINGS: Recently published recommendations and guidelines include the use of RT 3D TEE. RT 3 D TEE provides additional value particularly for guidance during cardiac interventions (i...
2017: Current Anesthesiology Reports
Barbara E Stähli, Thomas Stadler, Erik W Holy, Thi Dan Linh Nguyen-Kim, Lisa Hoffelner, Ladina Erhart, Slayman Obeid, Markus Niemann, Rolf Jenni, Sandra Hamada, Robert Manka, Thomas F Lüscher, Francesco Maisano, Fabian Nietlispach, Thomas Frauenfelder, Felix C Tanner
BACKGROUND: The prevalence of low flow low gradient (LFLG) severe aortic stenosis (AS) may be overrated due to underestimation of stroke volume in two-dimensional (2D) echocardiography. The implications of 3D imaging on stroke volume calculation for AS classification have not been elucidated. Integrating multi-detector computed tomography (MDCT) and Doppler data may improve diagnostic accuracy in patients with LFLG AS. METHODS: A total of 186 patients with severe AS evaluated for transcatheter aortic valve replacement were classified according to indexed stroke volume (SVI, cut-off 35mL/m2) and mean transaortic pressure gradient (cut-off 40mmHg)...
November 1, 2017: International Journal of Cardiology
Pedro Pinto Teixeira, Ruben Ramos, Pedro Rio, Luísa Moura Branco, Guilherme Portugal, Ana Abreu, Ana Galrinho, Hugo Marques, Luísa Figueiredo, Rui Cruz Ferreira
PURPOSE: Aortic valve area (AVA) is usually estimated by the continuity equation (CE) in which the left ventricular outflow tract (LVOT) area is calculated assuming a circular shape. This study aimed to compare measurements of LVOT area using standard 2D transthoracic echocardiography (2DTTE), 3D transesophageal echocardiography (3DTEE), and multidetector computed tomography (MDCT) and assess their relative impact on AVA estimated by the CE. METHODS AND RESULTS: We prospectively enrolled 60 patients with severe aortic stenosis (AS) referred for transcatheter aortic valve replacement (TAVR) who systematically underwent 2DTTE, 3DTEE, and MDCT...
July 2017: Echocardiography
Gry Dahle, Kjell-Arne Rein, Arnt E Fiane
OBJECTIVES: A transcatheter heart valve technique can be used in failed mitral valve repairs with annuloplasty rings, deterioriated bioprostheses and in mitral annular calcification, all serving as 'docking stations' for balloon-expandable valves. Specially designed transcatheter mitral valve platforms are used in ongoing studies for native mitral valve regurgitation. We present our single centre experience with transcatheter mitral valve implantation-transapical approach procedures in eleven patients...
August 1, 2017: Interactive Cardiovascular and Thoracic Surgery
Björn Goebel, Roland Heck, Ali Hamadanchi, Sylvia Otto, Torsten Doenst, Christian Jung, Alexander Lauten, Hans R Figulla, P Christian Schulze, Tudor C Poerner
Aims: Vena contracta area (VCA3D), derived by 3D colour Doppler echocardiography, has already been validated against cardiac magnetic resonance imaging, but the number of clinical studies to define cut-off values for grading of mitral regurgitation (MR) is limited. Aim of the study was to assess VCA3D in a large population of patients with functional (FMR) and degenerative MR (DMR). Methods and results: Transoesophageal echocardiography was performed in 500 patients with MR...
April 21, 2017: European Heart Journal Cardiovascular Imaging
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 Dhooge
A novel fully automatic framework for aortic valve (AV) trunk segmentation in three-dimensional (3-D) transesophageal echocardiography (TEE) datasets is proposed. The methodology combines a previously presented semiautomatic segmentation strategy by 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 3-D generalized Hough transform with a vessel-like dark tube detector to initialize the segmentation...
August 2017: 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
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