Yamaura Y, Yoshida K, Hozumi T, Akasaka T, Okada Y, Yoshikawa J
Division of Cardiology and Cardiovascular Surgery, Kobe General Hospital, Japan.
J Heart Valve Dis. 1997 Jan;6(1):43-7.
Three-dimensional (3D) echocardiography permits the objective analysis of structures and of pathologic conditions of complex geometry. Multiplane transesophageal echocardiography (TEE) permits 3D image sets of the heart to be produced from multiple 2D images by rotating the transducer, without changing its position. The purpose of this study was to clarify the capability of 3D echocardiography to evaluate the configuration and dynamics of the mitral annulus in patients fitted with an annuloplasty ring.
Twenty patients who underwent mitral valve repair for pure mitral regurgitation (10 with a flexible Duran ring and 10 with a rigid Carpentier ring) were studied. Using a multiplane transesophageal probe, sequential tomographic images were obtained by rotating the transducer at 2 degrees angular intervals around a 180 degrees arc. 3D reconstructions were performed to produce dynamic 3D images of the mitral annulus in a manner that simulated visualization from the left atrium. Mitral annular configuration was assessed from volume-rendered display and extractive 3D imaging. Mitral annular area change was evaluated from selected long-axis cut planes.
The configuration and dynamics of the mitral annulus were visualized by 3D displays. In patients with a Duran ring, the mitral annulus had a non-planar configuration and mitral annular area changed during cardiac cycle (increased in diastole; reduced in atrial and ventricular systole; percentage reduction 25 +/- 2%). In patients with a Carpentier ring, the mitral annulus had a planar configuration and mitral annular area was effectively unchanged during the cardiac cycle.
3D echocardiography using a multiplane transesophageal probe is useful in evaluating the configuration and dynamics of the mitral annulus in patients fitted with an annuloplasty ring.
三维（3D）超声心动图能够对复杂几何结构及其病理状况进行客观分析。多平面经食管超声心动图（TEE）可通过旋转换能器，在不改变其位置的情况下，由多个二维图像生成心脏的3D图像集。本研究的目的是阐明3D超声心动图评估植入瓣环成形环患者二尖瓣环形态及动态变化的能力。
对20例因单纯二尖瓣反流接受二尖瓣修复术的患者进行研究（10例植入柔性杜兰环，10例植入刚性卡彭蒂埃环）。使用多平面经食管探头，以2°角间隔围绕180°弧旋转换能器，获取连续断层图像。进行3D重建，以模拟从左心房观察的方式生成二尖瓣环的动态3D图像。从容积再现显示和提取式3D成像评估二尖瓣环形态。从选定的长轴切面评估二尖瓣环面积变化。
3D显示可观察到二尖瓣环的形态及动态变化。植入杜兰环的患者，二尖瓣环呈非平面形态，二尖瓣环面积在心动周期中发生变化（舒张期增大；心房和心室收缩期减小；减小百分比为25±2%）。植入卡彭蒂埃环的患者，二尖瓣环呈平面形态，二尖瓣环面积在心动周期中基本无变化。
使用多平面经食管探头的3D超声心动图有助于评估植入瓣环成形环患者二尖瓣环的形态及动态变化。
