Abstract 1868: Real-Time Three-Dimensional Echocardiographic Evaluation of Prosthetic Valves: Initial Experience with a Matrix Transesophageal Transducer
Background. Echocardiographic evaluation of prosthetic valves may be confounded by the inability to obtain en-face views with optimal resolution. 2D scanning with a multiplane probe and subsequent 3D reconstruction can provide unique views. However, this technique is time consuming and prone to artifacts. We used a novel real-time 3D transesophageal matrix array (RT3D mTEE) transducer to assess image quality of different valve prostheses.
Methods: 55 patients were studied (iE33, Philips) during clinically indicated TEE studies, including mechanical and bioprosthetic mitral valves (MV; N=16 and 5, respectively), MV annuloplasty rings (N=15), mechanical and bioprosthetic aortic valves (AV; N=7 and N=8, respectively) and bioprosthetic tricuspid valves (TV; N=4). RT3D en-face views were obtained in zoom mode and reviewed from both sides of the valve by 2 independent observers who graded the visualization (0 = <50% of the valve visualized; 1 = 50–75%; 2 = 75–90%; 3 = >90%). Ring and leaflets were scored individually.
Results. For all prosthetics, the annuloplasty rings were optimally visualized from both perspectives (figure⇓). While all remaining MV prosthetic valve components and post-repair MV leaflets were well visualized from both perspectives, AV and TV leaflets and struts were poorly visualized.
Conclusions. RT3D mTEE imaging provides unique views of prosthetic valves in real time. While in its current development phase, 3D visualization of the AV and TV is limited, RT3D mTEE is likely to become the diagnostic imaging modality of choice for the assessment of valve prosthesis.