Three-dimensional echocardiography in valve disease

Abstract

This review covers the role of three-dimensional (3D) echocardiography in the diagnosis of heart valve disease. Several factors have contributed to the evolution of this technique, which is currently a simple and routine method: rapid evolution in probe and computer technologies, demonstration that 3D data sets allowed more complete and accurate evaluation of cardiac structures, emerging clinical experience indicating the strong potential particularly in valve diseases, volume and function of the two ventricle measurements and several other fields. This report will review current and future applications of 3D echocardiography in mitral, aortic and tricuspid valve diseases underlying both qualitative (morphologic) and quantitative advantages of this technique.

Keywords: Three-dimensional transesophageal echocardiography; Three-dimensional transthoracic echocardiography; Valve disease.

Fig. 1

- 3DTTE reconstruction of a normal aortic valve: diastolic (left panel) and systolic (right panel) frames of the valve showing accurate evaluation of the leaflets and commissures. AO = aortic valve; LA = left atrium.

Fig. 2

- Surgical view of the mitral and tricuspid valves (diastolic frame). MV = mitral valve; TV= tricuspid valve.

Fig. 3

- Four cases of mitral valve disease. Upper left: 3DTTE reconstruction in a patient with mitral valve prolapse of the entire posterior leaflet (Barlow disease) with the three prolapsing scallops (arrow). Upper right: 3DTTE reconstruction in a mitral valve with a central cleft of the posterior leaflet (arrow). Lower left: 3DTEE reconstruction in a patient with an isolated prolapse of the anterolateral scallop of posterior leaflet (P1) (arrow). Lower right: 3DTEE reconstruction in a mitral valve with a cleft and prolapse of the medial scallop (P2) (arrow). MVPL = mitral valve posterior leaflet.

Fig. 4

- Two examples of bicuspid aortic valves. Left panel: 3DTTE reconstruction of a bicuspid valve in a systolic frame showing the two cusps and the rafe (arrow). Right panel: 3DTEE reconstruction (systolic frame) of a bicuspid valve. AO = aortic valve.