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Transesophageal Echocardiography for the Evaluation of Aorto‐Left Ventricular Tunnel in Adults, with Follow‐ups
Author(s) -
Xia Hongmei,
Jiang Yan,
Xu Yali,
Tang Jinliang,
Gao Yunhua
Publication year - 2015
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/echo.12870
Subject(s) - medicine , intracardiac injection , regurgitation (circulation) , mitral regurgitation , coronary sinus , commissure , cardiology , transesophageal echocardiogram , radiology , anatomy
Objective This study aims to compare the diagnostic accuracy of combined two‐dimensional (2D) and real time three‐dimensional (RT3D) transesophageal echocardiogram ( TEE ) imaging with the anatomic findings during surgery in adults with aorto‐left ventricular tunnel ( ALVT ). Background ALVT has typically been reported in infants rather than in adults. TEE appears to be a promising method of recognizing the spatial relationship of intracardiac structures. Methods Patients underwent comprehensive 2D and RT 3D TEE within 1 week preoperative and intraoperative. The TEE images were compared with the surgical findings. Results Nine patients diagnosed with ALVT using TEE were selected. The operations were successfully performed in 8 patients. The origin of the tunnels diagnosed by TEE was superior to the right coronary sinus ( RCS ) in 3 patients, superior to the commissure of the left coronary sinus ( LCS ) and the RCS in 3 patients, inferior to the junction of the LCS and noncoronary sinus ( NCS ) in 2 patients, and superior to the NCS in 1 patient. The surgical findings confirmed ALVT in 8 patients. The average diameter of the tunnel orifices in the LV or in the aorta measured by TEE versus surgery was 6.15 ± 3.21 mm versus 6.80 ± 3.91 mm (correlation displayed as r = 0.99, P < 0.0001). Seven (78%) patients had mild to severe aortic regurgitation, and 6 (67%) patients had mitral regurgitation. Conclusions A combination of 2D and RT 3D TEE imaging modalities would be needed to optimally define the anatomy and functional consequences of ALVT in adults.