Wasim Khan
Akron Children’s Hospital, USA
Title: Assessment of left sided valvular and non-valvular cardiac defects by three dimensional Echocardiography, in Pediatric and adult patients with congenital and acquired heart diseases
Biography
Biography: Wasim Khan
Abstract
OBJECTIVE and BACKGROUND: Three dimensional echocardiography (3DE) enhances the diagnostic capabilities of cardiac ultrasound. This study was performed to determine the utility of 3DE for acquiring superior anatomical detail for Left sided Valvular and non Valvular Cardiac defects. During early 1990s, von Ramm et al developed the first real-time 3D (RT3D) echocardiography scanner, capable of depicting cardiac motion using volumetric data. METHODOLOGY: Fifty eight 3D transthoracic echocardiograms (TTE) and transesophageal echocardiograms (TEE) were performed during January 2012 and April 2013 at Akron Children Hospital, Heart Centre, with specific indication to evaluate left sided cardiac defects. Patient age range was 4 months to 34 years, with varying diagnoses. IE-33 Philips Medical Systems was used. For Transthoracic 3DE using both reconstruction methods and RT3D, following images were obtained; parasternal long, short axis, apical 4 chamber, Sub costal and particular emphasis on area of interest. Supra-sternal notch were obtained if indicated. For TEE 3DE component using both reconstruction methods and RT3D, following images were obtained; apical 4 chambers with 0 degree angle left 2 chambers with 120 degree angle and particular emphasis on area of interest. Live 3D and off-line reconstruction was performed. Image quality (IQ) 5-level score was employed. RESULTS: Out of 56 studies 24 (43%) were TEE and 32 (57%) were TTE. 3DE was technically feasible in 92% with TTE and 100% with TEE in our study. Time for 3D acquisition, reconstruction and measurement was available in 40 patients and was 8-15 minutes. In TTE studies where 3DE was technically feasible, anatomical detail of cardiac valves and chambers was delineated with the IQ score ranging from 4 to 5. CONCLUSION: 3DE demonstrates detailed cardiac anatomy and has the potential to significantly alter clinical decision-making. 3DE provides improved accuracy and reproducibility over 2D methods.