Real-time transthoracic three-dimensional echocardiography provides additional information of left-sided AV valve morphology after AVSD repair

Aims: The purpose of this study was to assess the feasibility of real-time 3D echocardiography (RT-3DE) data acquisition in adult patients after atrioventricular septal defect (AVSD) repair and to evaluate whether RT-3DE has additional value over 2D echocardiography, regarding morphology and function of the left-sided AV valve (LAVV). Methods: Twenty consecutive patients with surgically corrected partial or complete AVSD were enrolled in this study. The 3DE data sets were acquired with the Hewlett-Packard Sonos 7500 echo system (Philips Medical Systems, Andover, MA, USA). Images were reviewed off-line with assistance of TomTec Echoview 5.2 software (TomTec Inc., Munich, Germany) by experienced observers. En face reconstructions, from, respectively, the ventricular and atrial view, were made to evaluate the LAVV morphology and motion. Results: 3DE reconstruction of the LAVV was feasible in 17 of 20 patients (85%). Mean time of 3DE acquisition was 9 ± 6 min. The quality of the 3DE images was optimal in 35%, good in 30%, sufficient in 20% and insufficient in 15%. Identification of the LAVV structures was importantly better facilitated from a ventricular view. Accurate identification of LAVV morphology was possible in all 17 patients (85%). Relationship of the LAVV and the abnormal position of the LVOT was easier to evaluate from the 3DE reconstructions than from 2D echo. Conclusion: This study demonstrate that RT-3DE is feasible in daily practice and provides new insight into the dynamic morphology of the left-sided AV valve and LVOT anatomy after AVSD repair.

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