Abstract
The surgeon's view by three-dimensional (3D) transesophageal echocardiography is widely accepted as a useful way of imaging in clinical settings. It allows us to easily understand the anatomy of the mitral valve in real time. Another useful way of imaging in 3D echocardiography is the multiplanar reconstruction (MPR) method, which enables us to crop the acquired 3D data and have optimal images that are difficult to visualize in two-dimensional echocardiography. Vena contracta area can be measured using MPR from the color Doppler 3D volume dataset to evaluate the severity of mitral regurgitation. Stich artifact is one of the limitations of 3D echocardiography, but minimizing the area of interest allows one-beat acquisition of high-quality volume data even in patients with atrial fibrillation. Transthoracic one-beat acquisition of the mitral orifice allows precise measurement of the orifice area with cropping of the true orifice by MPR. To visualize the submitral apparatus, including the papillary muscle and chordae tendineae, the transgastric approach in transesophageal echocardiography should be performed as an adjunct to the conventional mid-esophageal approach. 3D quantification, such as tenting volume or leaflet surface area, is one of the big advantages of 3D echocardiography. However, it does not easily lend itself to clinical settings, because it is labor-intensive and time-consuming. An automated approach for quantification that minimizes inter-operator variability needs to be developed not only for transesophageal but also for transthoracic images.
