Three-dimensional Echocardiography

280 Pages·2011·22.589 MB·English

by  Thomas Buck MD, FACC, FESC, Andreas Franke MD, FESC (auth.), Thomas Buck MD, FACC, FESC, Andreas Franke MD, FESC, Mark J. Monaghan PhD, FRCP(Hon), FACC, FESC (eds.)

t.buck · a.franke · m.j. monaghan

Editors
Three-dimensional
Echocardiography
Lehrprogramm
gemäß
(cid:2)(cid:3)§1(cid:4)4 JuSchG (cid:5)(cid:2)(cid:3)(cid:4)
R O M
Thomas Buck, Andreas Franke, Mark J. Monaghan (Editors)
Three-dimensional Echocardiography
Thomas Buck, Andreas Franke,
Mark J. Monaghan (Editors)
Three-dimensional
Echocardiography
With 248 figures including 825 single illustrations and 5 tables
1 23
Thomas Buck, MD, FACC, FESC Mark J. Monaghan, PhD, FRCP(Hon), FACC, FESC
Associate Professor of Medicine Professor of Echocardiography
Assistant Director, Department of Cardiology Director, Noninvasive Cardiology
Director, Echocardiography King’s College Hospital
West German Heart Center Essen London, UK
University Hospital Essen
Essen, Germany
Andreas Franke, MD, FESC
Associate Professor of Medicine
Head, Department of Cardiology, Angiology and
Intensive Care Medicine
Klinikum Region Hannover – Klinikum Siloah
Hannover, Germany
ISBN-13 978-3-642-11178-5 Springer-Verlag Berlin Heidelberg New York
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About the editors
Thomas Buck, MD, FACC, FESC
Thomas Buck is an Associate Professor of Medicine and Cardiology at the Uni-
versity Hospital of Essen, Germany. There he holds the position of Director of
Echocardiography Laboratories as well as the appointments of Chief Consultant and
Assistant Medical Director of the Department of Cardiology at the West German
Heart Center. Since the beginning of his academic career in 1992, three-dimensional
echocardiography has been a major field of his scientific interest. One of his primary
clinical areas of expertise is the management of heart valve disease patients, where
his early scientific work was stimulated while working as a Research Fellow at Mas-
sachusetts General Hospital. As one of his official assignments, he is currently acting
as the Chair of the German Working Group of Echocardiography. In addition to a
considerable number of scientific articles, his work includes several teaching book
contributions and international patents in the field of echocardiography. Since the
introduction of real-time 3D echocardiography into clinical practice, he has regu-
larly organized national and international training courses as an expert trainer.
Andreas Franke, MD, FESC
Andreas Franke is Associate Professor of Medicine and Cardiology and Director
of the Department of Cardiology, Angiology and Intensive Care Medicine of the
Klinikum Siloah in Hannover, Germany. During his clinical and academic career
starting in 1988 at the RWTH Technical University Aachen, echocardiography and
congenital heart disease in adults have been his main fields of scientific interest and
work. His primary clinical areas of expertise besides non-invasive cardiac imag-
ing are the interventional therapy of coronary artery disease and the management
of valvular disease. Since the early 90’s he was involved in further development of
three-dimensional echocardiography and published numerous clinical studies on
3D echo. Between 1998 and 2001 he was nucleus member of the Working Group
on Echocardiography of the ESC as organizer of the subgroup 3D echocardiogra-
phy. Over the last ten years he also contributed to several textbooks and atlases on
echocardiography. Moreover, since 2003 he regularly organizes national real-time
3D echocardiographic training courses as an expert trainer.
Mark J. Monaghan PhD, FRCP(Hon), FACC, FESC
Mark J. Monaghan is a Professor of Echocardiography and Director of Non-
Invasive Cardiology at King’s College Hospital, London UK. He has worked in the
field of Echocardiography for over 25 years and has published extensively on the
subject, especially on the use of 3D. In addition he holds two International patents
on Echo technology and lectures widely at International meetings and Cardiology
Conferences throughout the world. He runs several teaching Courses and Work-
shops on 3D Echocardiography every year and has contributed to and co-edited
several textbooks. Professor Monaghan has been a Board member of the European
Association of Echocardiography and is a past President of the British Society of
Echocardiography.
Table of contents
1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 4 Left ventricular function . . . . . . . . . . . . . . . 55
Thomas Buck, Andreas Franke, Harald P. Kühl
and Mark J. Monaghan 4.1 Assessment of left ventricular volumes
and ejection fraction . . . . . . . . . . . . . . . . . . . . . . .56
2 Three-dimensional echocardio- 4.2 Evaluation of left ventricular mass . . . . . . . . . .59
graphy: lessons in overcoming time 4.3 Assessment of regional left ventricular
and space . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 function . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .62
Jos R.T.C. Roelandt and Joseph Kisslo 4.4 Determination of left ventricular
2.1 Reconstruction techniques . . . . . . . . . . . . . . . . . .3 dyssynchrony . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .65
2.1.1 The linear scanning approach . . . . . . . . . . . . . . .4 4.5 Parametric imaging . . . . . . . . . . . . . . . . . . . . . . . .65
2.1.2 The fan-like scanning approach . . . . . . . . . . . . .6 4.6 Transesophageal real-time 3D echo-
2.1.3 The rotational scanning approach . . . . . . . . . . .6 cardiography . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .67
2.2 Volumetric real-time (high-speed) 4.7 Three-dimensional assessment of left
scanning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10 atrial volume and function . . . . . . . . . . . . . . . . .68
2.3 The future is based on the past . . . . . . . . . . . . .17 References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .70
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18
5 Three-dimensional stress
3 Basic principles and practical echocardiography . . . . . . . . . . . . . . . . . . . . . 73
application . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 Andreas Franke
Thomas Buck (with contribution by 5.1 Method . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .73
Karl E. Thiele, Philips Medical Systems, 5.2 Clinical studies on 3D stress echo-
Andover, MA, USA) cardiography . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .79
3.1 How real-time 3D ultrasound works . . . . . . . .21 5.3 Limitations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .80
3.1.1 It’s all about the transmit beams . . . . . . . . . . . .21 5.4 New approaches and future perspectives . . .80
3.1.2 The need for bigger, better, faster . . . . . . . . . .24 References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .80
3.1.3 Fully sampled matrix array transducers . . . . .24
3.1.4 Parallel receive beam processing . . . . . . . . . . .26 6 Cardiac dyssynchrony . . . . . . . . . . . . . . . . . 83
3.1.5 Three-dimensional color flow . . . . . . . . . . . . . .27 Mark J. Monaghan and Shaumik Adhya
3.2 The probes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .27 6.1 Technique . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .83
3.3 Live 3D echocardiographic 6.1.1 Acquisition of 3D volumes . . . . . . . . . . . . . . . . .83
examination . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .29 6.1.2 Measures of intraventricular
3.3.1 First steps and learning curve . . . . . . . . . . . . . .29 dyssynchrony . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .83
3.3.2 Three-dimensional acquisition 6.1.3 Performing 3D analyses . . . . . . . . . . . . . . . . . . . .86
(modes and image settings) . . . . . . . . . . . . . . . .29 6.1.4 Measurement variability . . . . . . . . . . . . . . . . . . .91
3.3.3 Standard 3D views . . . . . . . . . . . . . . . . . . . . . . . . .34 6.2 Normal values . . . . . . . . . . . . . . . . . . . . . . . . . . . . .92
3.4 Basic 3D analysis: cropping and 6.3 Dyssynchrony in heart failure and left
slicing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .40 bundle branch block . . . . . . . . . . . . . . . . . . . . . . .93
3.4.1 First steps of 3D dataset cropping . . . . . . . . . .40 6.3.1 Relationship between left ventricular
3.5 Basic 3D measurements . . . . . . . . . . . . . . . . . . . .48 function and dyssynchrony . . . . . . . . . . . . . . . .93
3.6 Artifacts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .48 6.3.2 Patterns of dyssynchrony . . . . . . . . . . . . . . . . . . .95
3.6.1 Stitching artifacts . . . . . . . . . . . . . . . . . . . . . . . . . .48 6.3.3 SDI as a predictor of outcome of cardiac
3.6.2 Dropout artifacts . . . . . . . . . . . . . . . . . . . . . . . . . .49 resynchronisation therapy . . . . . . . . . . . . . . . . .95
3.6.3 Blurring and blooming artifacts . . . . . . . . . . . .50 6.4 Dyssynchrony due to right ventricular
3.6.4 Gain artifacts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .51 pacing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .96
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .53 6.5 Dyssynchrony in other situations . . . . . . . . . . .97
VIII Table of contents
6.5.1 In children . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .97 9.4 Evaluation of prosthetic and
6.5.2 In congenital right heart disease . . . . . . . . . . .97 reconstructed valves . . . . . . . . . . . . . . . . . . . . . . . 171
6.5.3 After acute myocardial infarction . . . . . . . . . . .97 References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 172
6.5.4 In amyloidosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . .98
6.6 Assessment of dyssynchrony after CRT . . . . .98 10 Three-dimensional echocardiography
6.7 Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .98 in adult congenital heart disease . . . . . . 175
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .99 Folkert J. Meijboom, Heleen van der Zwaan,
and Jackie McGhie
7 The right ventricle . . . . . . . . . . . . . . . . . . .101 10.1 Patent foramen ovale . . . . . . . . . . . . . . . . . . . . . . 177
Stephan von Bardeleben, Thomas Buck, 10.2 Atrial septal defect . . . . . . . . . . . . . . . . . . . . . . . . . 177
and Andreas Franke 10.3 Ventricular septal defect . . . . . . . . . . . . . . . . . . . 182
7.1 Assessment of right ventricular volumes 10.4 Atrioventricular septal defects . . . . . . . . . . . . . 184
and function . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 104 10.5 Ebstein’s anomaly . . . . . . . . . . . . . . . . . . . . . . . . . . 187
7.2 New aspects of 3D right ventricular 10.6 Transposition of the great arteries . . . . . . . . . 189
analysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 107 10.7 Congenitally corrected transposition
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 107 of the great arteries . . . . . . . . . . . . . . . . . . . . . . . . 191
10.8 Tetralogy of Fallot . . . . . . . . . . . . . . . . . . . . . . . . . . 193
8 Valvular heart disease – 10.9 RT3DE in other congenital cardiac
insufficiencies . . . . . . . . . . . . . . . . . . . . . . .109 malformations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 193
Thomas Buck 10.10 The role of RT3DE in the analysis of
8.1 Mitral regurgitation . . . . . . . . . . . . . . . . . . . . . . 109 right ventricular function . . . . . . . . . . . . . . . . . . 193
8.1.1 Evaluation of mitral valve insufficiency . . . 109 10.10.1 Acquisition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 193
8.1.2 Classification of mitral valve 10.10.2 Analysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 196
insufficiency . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111 10.11 Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 196
8.1.3 Mitral valve prolapse, flail and Barlow’s References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 198
disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 112
8.1.4 Mitral valve quantification . . . . . . . . . . . . . . . . 116 11 Congenital heart disease in
8.1.5 Papillary muscle rupture . . . . . . . . . . . . . . . . . 121 children . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 201
8.1.6 Functional mitral regurgitation . . . . . . . . . . . 122 John M. Simpson
8.1.7 Endocarditis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 125 11.1 Technical and patient-specific factors . . . . . . 201
8.1.8 Mitral valve prosthesis . . . . . . . . . . . . . . . . . . . 126 11.2 Selection of imaging probes in children . . . . 202
8.1.9 Mitral valve repair . . . . . . . . . . . . . . . . . . . . . . . . 128 11.3 Presentation of 3D echocardiographic
8.1.10 Rare etiologies . . . . . . . . . . . . . . . . . . . . . . . . . . . 132 images . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 202
8.1.11 Assessment of severity of mitral 11.4 Types of cardiac lesions which can be
regurgitation . . . . . . . . . . . . . . . . . . . . . . . . . . . . 133 assessed using 3D echocardiography . . . . . . 203
8.2 Aortic regurgitation . . . . . . . . . . . . . . . . . . . . . . 143 11.4.1 Abnormalities of venous drainage . . . . . . . . . 203
8.3 Right-sided heart valves . . . . . . . . . . . . . . . . . . 149 11.4.2 Atrial septal defects . . . . . . . . . . . . . . . . . . . . . . . . 203
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 151 11.4.3 Ventricular septal defects . . . . . . . . . . . . . . . . . . 204
11.4.4 Atrioventricular valves . . . . . . . . . . . . . . . . . . . . . 208
9 Valvular heart disease – stenoses . . . . .155 11.4.5 Atrioventricular septal defects . . . . . . . . . . . . . 208
Jose L. Zamorano and Jose Alberto de Agustín 11.4.6 Mitral valve abnormalities . . . . . . . . . . . . . . . . . 208
9.1 Evaluation of mitral valve stenosis . . . . . . . . 155 11.4.7 Ebstein’s anomaly of the tricuspid valve . . . . 208
9.1.1 Morphological assessment of the mitral 11.4.8 Atrioventricular junction . . . . . . . . . . . . . . . . . . . 208
valve . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 155 11.4.9 Complex anatomy . . . . . . . . . . . . . . . . . . . . . . . . . 212
9.1.2 Functional assessment of mitral stenosis . . 155 11.5 Three-dimensional echocardiography
9.2 Evaluation of aortic valve stenosis . . . . . . . . 162 during catheter intervention and
9.2.1 Morphological assessment of aortic surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 214
stenosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 162 11.5.1 Imaging during catheter intervention . . . . . . 214
9.2.2 Functional assessment of aortic 11.5.2 Three-dimensional imaging during
stenosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 164 surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 214
9.3 Evaluation of tricuspid and pulmonary 11.6 Role of RT3DE in the assessment of
valve stenosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . 171 cardiac function in children . . . . . . . . . . . . . . . . 217
Table of contents IX
11.6.1 The left ventricle . . . . . . . . . . . . . . . . . . . . . . . . . . . 217
11.6.2 The right ventricle . . . . . . . . . . . . . . . . . . . . . . . 217
11.7 Conclusions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 219
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 219
12 Cardiac tumors and sources of
embolism . . . . . . . . . . . . . . . . . . . . . . . . . . . .223
Björn Plicht
12.1 Sources of embolism . . . . . . . . . . . . . . . . . . . . . 223
12.1.1 Cardiac and vascular thrombi,
spontaneous echo contrast . . . . . . . . . . . . . . 223
12.1.2 Patent foramen ovale . . . . . . . . . . . . . . . . . . . . 226
12.1.3 Infective endocarditis . . . . . . . . . . . . . . . . . . . . 231
12.2 Primary cardiac tumors . . . . . . . . . . . . . . . . . . 233
12.2.1 Primary benign cardiac tumors . . . . . . . . . . . 233
12.2.2 Primary malignant tumors . . . . . . . . . . . . . . . 236
12.3 Secondary cardiac tumors and
metastases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 236
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 239
13 Monitoring and guiding cardiac
interventions and surgery . . . . . . . . . . . .241
Harald P. Kühl, Andreas Franke,
and Thomas Buck
13.1 Method . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 241
13.2 Intraoperative monitoring and guiding . . . 241
13.3 Periinterventional monitoring and
guiding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 244
13.3.1 Transcatheter closure of PFO and ASD . . . . 244
13.3.2 Transcatheter closure of VSD . . . . . . . . . . . . . 248
13.3.3 Percutaneous aortic valve implantation . . . 248
13.3.4 Percutaneous mitral repair . . . . . . . . . . . . . . . 249
13.3.5 Left atrial appendage occluder
implantation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 256
13.3.6 Percutaneous occluder implantation
for paravalvular leaks . . . . . . . . . . . . . . . . . . . . 258
13.3.7 Percutaneous mitral valvuloplasty . . . . . . . . 259
13.3.8 Electrophysiological procedures . . . . . . . . . . 263
13.4 Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 263
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 263
Subject index . . . . . . . . . . . . . . . . . . . . . . . .267
List of authors
Adhya, Shaumik, BSc MBBS MRCP CCDS McGhie, Jackie
Clinical Research Fellow Chief sonographer
King’s College Hospital Department of Cardiology
London, UK The Thoraxcenter
Erasmus University Medical Center
de Agustín, Jose Alberto Rotterdam, the Netherlands
Senior Staff
Universidad Complutense de Madrid Meijboom, Folkert J., MD, PhD, FESC
University Clinic San Carlos GUCH & pediatric cardiologist
Madrid, Spain Dept of Pediatrics and Cardiology
University Medical Centre Utrecht,
von Bardeleben, Stephan, MD Utrecht, the Netherlands
Director, Echocardiography
Department of Cardiology Monaghan, Mark J., PhD, FRCP(Hon), FACC, FESC
University Hospital Mainz Professor of Echocardiography
Mainz, Germany Director, Noninvasive Cardiology
King‘s College Hospital
Buck, Thomas, MD, FACC, FESC London, UK
Associate Professor of Medicine
Assistant Director, Department of Cardiology Plicht, Björn, MD
Director, Echocardiography Senior Cardiologist
West German Heart Center Essen Department of Cardiology
University Hospital Essen West German Heart Center Essen
Essen, Germany University Hospital Essen
Essen, Germany
Franke, Andreas, MD, FESC
Associate Professor of Medicine Roelandt, Jos R.T.C., MD, PhD, FESC
Head, Department of Cardiology, Angiology and Professor of Cardiology
Intensive Care Medicine Emeritus Chairman Thoraxcenter
Klinikum Region Hannover – Klinikum Siloah Erasmus University Medical Center
Hannover, Germany Rotterdam, the Netherlands
Kisslo, Joseph, MD Simpson, John M., MD, FRCP, FESC
Professor of Medicine Consultant in Paediatric and Fetal Cardiology
Duke University Medical Center Director of Paediatric Echocardiography
Durham, NC, USA Evelina Children’s Hospital
Guy’s and St Thomas’ NHS Foundation Trust
Kühl, Harald P., MD London, UK
Associate Professor of Medicine
Head, Department of Cardiology Thiele, Karl E., ME
Städtisches Klinikum München – Klinikum Harlaching Principal Scientist
Munich, Germany Philips Healthcare
Andover, MA, USA
XII List of authors
van der Zwaan, Heleen
Senior Staff
Department of Cardiology
The Thoraxcenter
Erasmus University Medical Center
Rotterdam, the Netherlands
Zamorano, Jose L., MD, FESC
Professor of Medicine
Universidad Complutense de Madrid
Director, Cardiovascular Institute
University Clinic San Carlos
Madrid, Spain