Abstract
How can we utilize real-time three-dimensional (3D) echocardiography for diagnosis and treatment of congenital heart diseases? One of the most effective applications is to obtain critical information on complicated intracardiac 3D structures of the heart for planning of cardiac surgery, such as creation of an intracardiac route via a ventricular septal defect in patients with double outlet right ventricle, valvuloplasty for complicated atrioventricular valve regurgitation, or repair of intracardiac stenotic lesions. It is also useful for determining whether catheter intervention is indicated and for monitoring the procedure (while 3D echocardiography is only used for percutaneous atrial septal defect closure in Japan, it is also used for percutaneous ventricular septal defect closure in the US and Europe). Furthermore, transpericardial real-time 3D echocardiography is performed by placing the ultrasound probe directly onto the pericardium enables us to collect volume data with a high SN ratio and image resolution in pediatric patients for whom transesophageal echocardiography cannot be applied. This approach also enables both cardiovascular surgeons and cardiologists to share the ‘surgeon's view’ in the operating room. A new type to fetal echocardiography using the spatiotemporal image correlation (STIC) technique, which can reconstruct 3D fetal heart images by triggering the fetal cardiac motion, has been applied to fetal heart disease screening. Further investigations of 3D cardiac and valvular functions in congenital heart diseases are necessary to predict and improve the morbidity and the mortality of congenital heart diseases.
