Background: Recent advances in three-dimensional (3D) echocardiography allow to obtain real-time 3D transesophageal (RT3DTEE) images intraoperatively. Methods: Preoperative transthoral echocardiography (TTE) revealed: hypertrophic ventricular septum (TTE:19.3 mm), systolic anterior motion (SAM) not causing obstruction and malcoaptation of the anterior mitral valve leaflet (AMVL), and posterior mitral valve leaflet (PMVL) with severe mitral regurgitation. Results: Intraoperative TEE with a x7-2t MATRIX-array transducer (Philips, Andover, MA, USA) with a transducer frequency of x7-2 t mHz, connected to a iE33 (Philips), shows us that the main mechanism and site of regurgitation was an AMVL cleft. We also measured a 24.3-mm thickness of the ventricular septum and analyzing the 3D full volume acquisition revealed that there was no SAM. Conclusion: Intraoperative RT3DTEE permitted comprehensive 3D viewing of the mitral valve revealing the mechanism of mitral valve regurgitation, SAM, and the exact width of the hypertrophic ventricular septum.

dx.doi.org/10.1111/j.1540-8191.2008.00666.x, hdl.handle.net/1765/29832
Journal of Cardiac Surgery
Erasmus MC: University Medical Center Rotterdam

Scohy, T.V, ten Cate, F.J, Lecomte, P.V.E.L, Vletter-McGhie, J.S, de Jong, P.L, Hofland, J, & Bogers, A.J.J.C. (2008). Usefulness of intraoperative real-time 3D transesophageal echocardiography in cardiac surgery. Journal of Cardiac Surgery, 23(6), 784–786. doi:10.1111/j.1540-8191.2008.00666.x