Hostname: page-component-cd9895bd7-7cvxr Total loading time: 0 Render date: 2024-12-24T02:14:33.740Z Has data issue: false hasContentIssue false

The application of transthoracic dynamic three-dimensional echocardiography by computer-controlled parallel slicing in patients with fixed subaortic obstruction

Published online by Cambridge University Press:  19 August 2008

Michael Vogel*
Affiliation:
From the Department of Pediatric Cardiology, Deutsches Herzzentrum München, München
Shideh Lösch
Affiliation:
From the Department of Pediatric Cardiology, Deutsches Herzzentrum München, München
Konard Bühlmeyer
Affiliation:
From the Department of Pediatric Cardiology, Deutsches Herzzentrum München, München
*
Dr. Michael Vogel, Kinderkardiologie am Deutschen Herzzentrum München, Lothstraße1 1, D-8000 München 2, Germany. Tel. 49 89 1209 450; Fax. 49 89 1209 547.

Abstract

A 64-element phased-array echocardiographic transducer mounted on a sliding carriage was used transthoracically in 11 patients with subaortic obstruction caused by various different morphological substrates. The transducer is moved in a plane from the outflow tract to the apex of the heart in steps of 0.5 to 1.3 mm and records a tomographic slice of the heart at each step. Parallel images are recorded at a frame rate of 25–30 images per second and triggered to heart rate and respiration. A complete cardiac cycle is recorded at each level. The images are digitized and stored in the image-processing computer, which reconstructs the anatomic structures of the heart in a three-dimensional format by means of different gray-scales. Good quality echocardiographic pictures were obtained in 10 of the 11 patients and three-dimensional reconstructions were possible in those 10 patients. The technique is able to display the heart in real-time in any desired plane, and in up to five planes simultaneously, without the need to change the position of the transducer on the chest. Thus the best views with which to display the substrate of subaortic stenosis could be selected. The left ventricular outflow tract could also be displayed in a view similiar to the one obtained by the surgeon during operative procedures for resection of the subaortic stenosis through an incision in the aortic root. Image acquisition took three to five minutes, and three-dimensional reconstruction of various cardiac structures took 20–90 minutes. Display of the subaortic area in three-dimensional format may enhance our understanding of cardiac anatomy and identify the different morphological lesions in the left ventricular outflow tract which cause subaortic obstruction.

Type
World Forum for Pediatric Cardiology Young Investigator Finalists
Copyright
Copyright © Cambridge University Press 1994

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Kandah, T, Kimball, TR, Daniels, SR, Meyer, RA, Gaum, WE, Hannon, DW, Morrison, S, Schwartz, DC.When is echocardiography unreliable in patients undergoing catheterization for pediatric cardiovascular disease? J Am Soc Echo 1991; 4:5156.CrossRefGoogle ScholarPubMed
Edwards, JE.Pathology of left ventricular outflow tract obstruction. Circulation 1965; 32: 586599.CrossRefGoogle Scholar
Dekker, DL, Piziali, R, Dong, E.A system for ultrasonically imaging the human heart in three dimensions. Comput Biomed Res 1974; 7: 544553.CrossRefGoogle ScholarPubMed
Matsumoto, M, Matsuo, H, Kitabatake, A, Inone, M, Hamake, Y, Tamura, S, Tanaka, K, Abe, H.Three-dimensional echocardiograms and two-dimensional echocardiographic images at de sired planes by a computerized system. Ultrasound Med Biol 1977; 3: 163169.CrossRefGoogle Scholar
Geiser, EA, Ariet, M, Conetta, DA, Lupkiewicz, SM, Christie, LG Jr, Conti, CR.Dynamic three-dimensional echocardiographic reconstruction of the intact human left ventricle: technique and initial observations in patients. Am Heart J 1982;103: 10561065.CrossRefGoogle ScholarPubMed
Raichlen, JS, Trivedi, SS, Herman, GT, StJohn Sutton, MG, Reichek, N.Dynamic three-dimensional reconstruction of the left ventricle from two-dimensional echocardiograms. J Am Coll Cardiol 1986; 8: 364370.CrossRefGoogle ScholarPubMed
Sheikh, KH, Smith, SW, vonRamm, O, Kisslo, J.Real-time, three-dimensional echocardiography: Feasibility and initial use. Echocardiography 1991; 8: 119125.CrossRefGoogle ScholarPubMed
Nanda, NC, Pinheiro, L, Sanyal, R, Rosenthal, S, Kirklin, JK.Multiplane transoesophageal echocardiographic imaging and three-dimensional reconstruction. Echocardiography 1992;9: 667676.CrossRefGoogle Scholar
Wollschläger, H, Zeiher, AM, Klein, HP, Kasper, W, Geibel, A, Wollschläger, S.Transesophageal echo computer tomography:a new method for dynamic 3-D imaging of the heart. Circulation 1989; 80(Suppl IIyes): II 569. [Abstract]Google Scholar
Wilcox, WD, Seward, JB, Hagler, DJ, Mair, DD, Tajik, A.Discrete subaortic stenosis: two-dimensional echocardiographic features with angiographic and surgical correlation. Mayo Ciin Proc 1980; 55: 425432.Google ScholarPubMed
Vogel, M, Smallhorn, JF, Freedom, RM, Coles, J, Williams, WG, Trusler, GA.An echocardiographic study of the association of ventricular septal defect and right ventricular muscle bundles with a fixed subaortic abnormality. Am J Cardiol 1988; 61:857860.CrossRefGoogle ScholarPubMed
Freedom, RM, Pelech, A, Brand, A, Vogel, M, Williams, WG, Trusler, GA, Rowe, RD. The progressive nature of subaortic stenosis in congenital heart disease. Int J Cardiol 1985; 8: 137143.CrossRefGoogle ScholarPubMed
Somerville, J.Congenital heart disease—changes in form and function. Br Heart J 1979; 41: 122.CrossRefGoogle ScholarPubMed
Vogel, M, Freedom, RMBrand, A, Trusler, GA, Williams, WG, Rowe, RD.Ventricular septal defect and subaortic stenosis: an analysis of 41 patients. Am J Cardiol 1983; 52: 12581263.CrossRefGoogle ScholarPubMed
Shem-Tov, A, Schneeweis, A, Motro, M, Neufeld, HN.Clinical presentation and natural history of mild discrete subaortic stenosis. Circulation 1982; 66: 509512.CrossRefGoogle ScholarPubMed
King, DL, Harrison, MR, King, DL Jr,, Gopal, AS, Martin, RP, deMaria, AN.Improved reproducibility of left atrial and left ventricular measurements by guided three-dimensional echocardiography. J Am Coll Cardiol 1992; 20: 12381245.CrossRefGoogle ScholarPubMed
Martin, RW, Bashein, G.Measurement of stroke volume with three-dimensional transesophageal ultrasonic scanning: comparison with thermodilution measurement. Anesthesiology 1989; 70: 470476.CrossRefGoogle ScholarPubMed
Pandian, NG, Nanda, NC, Schwartz, SL, Fan, PCao, Q-L, Sanyal, R, Hsu, T-L, Mumm, B, Wollschläger, H, Weintraub, A.Three-dimensional and four-dimensional transesophageal echocardiographic imaging of the heart and aorta in humans using a computed tomographic imaging probe. Echocardiography 1992; 9: 677687.CrossRefGoogle ScholarPubMed