MORPHOLOGY AND DYNAMIC CHANGE OF DISCRETE SUBAORTIC STENOSIS CAN BE IMAGED AND QUANTIFIED WITH 3-DIMENSIONAL TRANSESOPHAGEAL ECHOCARDIOGRAPHY

This report describes three-dimensional transesophageal echocardiograp hic findings in three consecutive patients with discrete subaortic ste nosis. The discrete subaortic stenosis lesions included a circumferent ial, a remnant crescent, and a broken fibrotic subaortic membrane. The lesions were best imaged by using a three-dimensional transesophageal echocardiography-generated ''aortotomy view'' of the left ventricular outflow tract immediately below the plane of the aortic valve. The th ree-dimensional images correlated well with surgical and pathologic fi ndings. The three-dimensional surface areas of the left ventricular ou tflow tract at the level of discrete subaortic stenosis during systole (0.8 +/- 0.5 cm(2)) and diastole (1.7 +/- 0.7 cm(2)) were measured by planimetry of the three-dimensional transesophageal echocardiographic images. The novel ''aortotomy view'' offered by three-dimensional tra nsesophageal echocardiography provided direct visualization and quanti fication of discrete subaortic stenosis in a dynamic fashion. In summa ry, three-dimensional trans esophageal echocardiography can accurately display and quantify discrete subaortic stenosis and could be a new c linically useful tool for assessing discrete subaortic stenosis and gu iding surgical and transcatheter interventions.