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3 Dimensional TEE Echocardiography

3 Dimensional TEE Echocardiography. Roberto M Lang, MD. University of Chicago. An internist heard a murmur …. 47 year old physics professor Bicycles over 100 miles a week Noted a mild decrease in exercise tolerance.

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3 Dimensional TEE Echocardiography

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  1. 3 Dimensional TEE Echocardiography Roberto M Lang, MD University of Chicago

  2. An internist heard a murmur … • 47 year old physics professor • Bicycles over 100 miles a week • Noted a mild decrease in exercise tolerance

  3. When we look at biplane long axis views, we see that the patient has a flail P2 segment with jet of mitral regurgitation which is moving and which is going in an inferior direction.  Qualitatively the severity of the mitral regurgitation is severe.

  4. Pre –Op: Flail P2; Severe MR

  5. These are zoomed views of the mitral valve showing the presence of prolapse in the P2 segment.  If you look carefully, particularly in the image on the right in which we are visualizing the left atrium from the left atrial perspective,  we see two flail leaflets

  6. P2 Flail

  7. P2 Flail We see long axis views in which we see 3D color Doppler in the formation of a 3D Pisa.

  8. P2 and P3 Prolapse

  9. Ruptured Chords

  10. Surgical Findings

  11. LV Function Pre and Post MV Repair EDV = 141 ml ESV = 72 ml LV EF = 49% EDV = 93 ml ESV = 33 ml LV EF = 64%

  12. MV Repair and Annuloplasty with ST Jude Ring

  13. MV Repair and Annuloplasty with ST Jude Ring

  14. Model Valve P2 and P3

  15. Interatrial Septum – Data Acquisition

  16. Interatrial Septum 90 % IAS FO MV LV LA View Sugeng L, Lang RM; J Am Coll Cardiol

  17. Ostium Secundum ASD

  18. Evaluation Device Position LA disc RA disc

  19. Conclusions • RT3D TEE is feasible and provides an unique views of the MV, LAA, PV and IAS • RT3D TEE imaging of prosthetic valves yields unique perspectives • RT3D TEE will be the method of choice to monitor different percutaneous procedures

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