Dynamic Three-Dimensional Reconstruction of Abnormal Intracardiac Blood Flow

Dynamic three-dimensional (3-D) echocardiography has so far focused on reconstruction of cardiac structures. In this preliminary study, abnormal intracardiac blood flow has been reconstructed in 3-D from multiplane transesophageal and transthoracic two-dimensional (2-D) echocardiograms using modified omniplane probes with 3.7- or 5.0-MHz transducers. The study group included patients with native (40) and prosthetic (11) mitral regurgitant jets, aortic regurgitant jets (8), and shunt flow in atrial septal defect (20), ventricular septal defect (19), tetralogy of Fallot (14), and ruptured sinus of Valsalva aneurysm (6). For dynamic 3-D intracardiac flow imaging the gain of 2-D images of cardiac structures was lowered slightly and color Doppler flow signals were transformed into gray scale flow signals, which were then collected in the TomTec 3-D Echo Scan System. Dynamic 3-D cardiac flow images were displayed with volume rendering. The results indicated that dynamic 3-D cardiac flow imaging facilitates display of the stereo shape, spatial orientation, profiles and volume of regurgitant jets, and the intracardiac shunting blood flow. It allows differentiation of prosthetic transvalvular from paravalvular regurgitant jets. Limitations include nonvelocity and nonECG synchronized display.