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Incremental Utility of Real Time Three‐Dimensional Tranthoracic Echocardiography in the Assessment of Congenitally Malformed Aortic Valve
Author(s) -
Anwar Ashraf M.,
Nosir Youssef F. M.,
Galal Ahmed N.,
AlBarakati Mai,
ChamsiPasha Hassan
Publication year - 2012
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/j.1540-8175.2012.01711.x
Subject(s) - medicine , ventricular outflow tract , cardiac skeleton , nuclear medicine , cardiology , aortic valve , radiology , aortic root , aorta
Objectives: To study the feasibility and additional value of real time three‐dimensional transthoracic echocardiography (RT3D‐TTE) for anatomical and functional assessment of malformed aortic valve (AV) compared to conventional two‐dimensional TTE (2D‐TTE). Methods: Malformed AV was evaluated in 35 patients (mean age 18 ±9.5years, 70% male) by both 2D‐TTE and RT3D‐TTE. The anatomical definition of aortic cusps (number, direction, and commissures) was evaluated by a 3‐point visualization score (1: nonvisualized, 2: inadequate, 3: adequate). 2D‐TTE and RT3D‐TTE measurements included AV area and maximum diameters of both AV annulus and left ventricular outflow tract (LVOT). Results: Adequate visualization of AV cusps was achieved in 86% of patients by RT3D‐TTE compared to 63% by 2D‐TTE. The mean and median visualization score obtained by RT3D‐TTE were higher than that by 2D‐TTE. The opening of commissures was detected in (80%) of patients by RT3D‐TTE compared to (34%) by 2D‐TTE. AV area planimetry could be obtained in 77% of patients by RT3D‐TTE compared to 43% by 2D‐TTE. RT3D‐TTE visualization score of AV cusps and commissures showed better interobserver agreement (Kappa: 0.62 and 0.72, respectively) than 2D‐TTE (0.58 and 0.69, respectively). RT3D‐TTE and 2D‐TTE measurements of AV annulus and LVOT were well correlated (r = 0.85; P < 0.001) but the RT3D‐TTE measurements were significantly larger than that obtained by 2D‐TTE (2.05 ± 0.7 cm and 2.5 ± 0.86 cm vs 1.94 ± 0.67 cm and 1.98 ± 0.74 cm; P < 0.01). Conclusion: RT3D‐TTE is a feasible technique that allows comprehensive quantitative and qualitative assessment of malformed AV. (Echocardiography, 2012;**:1‐6)