Three-dimensional echocardiography in adult patients: Comparison between transthoracic and transesophageal reconstructions

Background: Three-dimensional (3D) echocardiography is a relatively new tec hnique typically implemented with transesophageal imaging with multiplane t ransducers. Objectives: The goals of this study were (1) to test the feasibility of 3D reconstruction with a new transthoracic multiplane transducer in adult subj ects with excellent quality of 2-dimensional images and (2) to compare thes e reconstructions with those obtained in the same patients with the transes ophageal approach. Methods: Transthoracic multiplane image acquisition was performed in 37 pat ients who were selected on the basis of the quality of their 2-dimensional images. In addition, transesophageal acquisition was also performed in 19 o f 37 patients. Three-dimensional reconstruction of mitral and aortic valves was performed. Three-dimensional images were reviewed, and the visualizati on of various anatomic features was graded. Results: The reconstruction of 25 mitral valves and 16 aortic valves, norma l and pathologic, was feasible and resulted in visualization of anatomic de tail. Score indexes of all valvular characteristics studied were not signif icantly different when transthoracic and transesophageal reconstructions we re compared. Conclusions: Transthoracic 3D echocardiography with a multiplane transducer in adult patients with good acoustic windows is feasible. This technique w ill allow easy noninvasive serial assessment of valvular pathophysiologic c haracteristics.