The Use of Three-dimensional Echo in Clinical Practice

Volume 1, Jan 2012

Carly Jenkins, Sudhir Wahi; Queensland, Australia

Three-dimensional echocardiography (3DE) is an imaging modality that is rapidly gaining clinical application. Since its introduction in 1973, it has emerged from an unwieldy research modality to a practical and readily available clinical tool in the last decade. 

The four major focus areas with an established role for 3DE include the analysis of cardiac volumes and left ventricular (LV) mass, ischemic heart disease, congenital heart disease and valvular pathology. The real time display of the deeper cardiac structures in a three dimensional plane improves the diagnostic capabilities and discards any geometric assumptions included in the two-dimensional data set. The reduced foot print of the current generation of 3DE imaging transducer allows a larger real time data pyramid. This is particularly useful when precise measurements of chamber volumes may be important for decision making, for example in the assessment of patients with reduced LV function when considering implantable defibrillators or cardiac resynchronisation therapy. Another important application of 3DE is in the guidance of interventional cardiac procedures, namely, mitral valve balloon valvuloplasty, percutaneous atrial and ventricular septal defect closure and in percutaneous closure of para-prosthetic mitral and aortic regurgitation. 

The ability of 3DE to simulate surgical views helps to facilitate vital surgical decisions and planning for mitral and aortic valve repair. It is instrumental in the selection and performance of percutaneous aortic valve implantation and mitraclip repair for mitral regurgitation.  Finally it may help in making more accurate qualitative diagnosis and classification of congenital heart disease.

Key Words: 3D echo; clinical practice; review.

Volume 1, Number 1, Page: 11-9.