DYNAMIC 3-DIMENSIONAL CARDIAC RECONSTRUCT ION BY TRANSESOPHAGEAL ECHOCARDIOGRAPHY - CLINICAL-EXPERIENCE WITH 100 CASES

Three-Dimensional (3D) echocardiography was performed during routine t ransesophageal examinations in 100 patients to identify the most promi sing applications. The approach used was based on the integration of m ultiple two-dimensional images recorded with a multiplane probe to ach ieve 3D reconstruction. A series of 90 cardiac cycles was recorded fro m a fixed position during computer-controlled rotation of the transduc er. The images were digitized, then reorganized according to their spa tial and temporal location. The cardiac structures were then represent ed dynamically in three dimensions. In 100 patients referred for trans esophageal echocardiography, the 3D reconstruction provided good quali ty images. under new angles, such as the view of the atrial aspect of the mitral valve as seen from the roof of the left atrium. This method was particularly well suited to assess mitral valve prolapse or steno sis. The spatial extent, direction and number of jets of mitral regurg itation were easily appreciated throughout systole, as were the regurg itant jets of mechanical prosthetic valves. However, the sensitivity o f the 3D method was not as good as 2D echocardiography for detecting b acterial vegetations in cases of infective endocarditis. On the other hand, the determination of the precise localization of infectious, deg enerative and tumoral lesions and their size were facilitated by 3D re construction. The authors conclude that 3D echocardiography is applica ble in routine practice and the complementary information provided in certain cardiac diseases should help management of these patients.