[Dynamic three-dimensional cardiac reconstruction by transesophageal echocardiography. A clinical experience apropos...

Three-Dimensional (3D) echocardiography was performed during routine transesophageal examinations in 100 patients to identify the most promising applications. The approach used was based on the integration of multiple two-dimensional images recorded with a multiplane probe to achieve 3D reconstruction. A series of 90 cardiac cycles was recorded from a fixed position during computer-controlled rotation of the transducer. The images were digitized, then reorganized according to their spatial and temporal location. The cardiac structures were then represented dynamically in three dimensions. In 100 patients referred for transesophageal echocardiography, the 3D reconstruction provided good quality images, under new angles, such as the view of the atrial aspect of the mitral valve as seen from the roof of the left atrium. This method was particularly well suited to assess mitral valve prolapse or stenosis. The spatial extent, direction and number of jets of mitral regurgitation were easily appreciated throughout systole, as were the regurgitant jets of mechanical prosthetic valves. However, the sensitivity of the 3D method was not as good as 2D echocardiography for detecting bacterial vegetations in cases of infective endocarditis. On the other hand, the determination of the precise localization of infectious, degenerative and tumoral lesions and their size were facilitated by 3D reconstruction. The authors conclude that 3D echocardiography is applicable in routine practice and the complementary information provided in certain cardiac diseases should help management of these patients.