Abstract 14621: The Utility of Three-Dimensional Transesophageal Echocardiography in the Diagnosis of Valvular Perforations
Introduction: Over the past 2 years, 3-dimensional transesophageal echocardiography (3DTEE) has demonstrated utility in the assessment of a variety of cardiac pathologies. We compared 3DTEE with 2-dimensional transesophageal echocardiography (2DTEE) in the diagnosis and evaluation of cardiac valve perforations.
Methods: We reviewed inpatient echocardiographic data from a single center hospital during a 15 month period and identified patients with native heart valve perforations who underwent evaluation with 2DTEE and 3DTEE. Images from these studies were reviewed by two blinded expert cardiologists who were asked to document the presence and location of valve perforations and to document their degree of confidence in the diagnosis of valve perforation for each type of TEE. Confidence was scored according to a predefined 5 point scale with 1 indicating a very poor confidence and 5 indicating excellent confidence. A confidence level of 5 was considered diagnostic. Reviewers were also asked to comment on observed differences between 2DTEE and 3DTEE in the evaluation of perforations.
Results: Review of 2DTEE images resulted in the identification of 11 valve perforations. Review of 3DTEE images resulted in the identification of 15 perforations including 4 perforations that were not seen on 2DTEE. Based on reviewer comments, the ability of 3DTEE to provide en-face anatomic views of cardiac valves allowed for a more precise characterization of the size, location, and shape of valve perforations when compared with 2DTEE.
Conclusion: We report success with the use of 3DTEE in the diagnosis and evaluation of cardiac valve perforations. 3DTEE provides added benefit to 2DTEE because of its increased ability to detect perforations and because of its ability to provide en-face anatomic views of cardiac valves, allowing for a more precise characterization of the size, shape, and location of valve perforations.
- © 2010 by American Heart Association, Inc.