Department  of  Cardiac,  Thoracic  and  Vascular  Sciences  University  of  Padua,  School  of  Medicine  

Padua,  Italy  

IL  PAZIENTE  VALVOLARE  E  IL  3D    

Denisa  Muraru,  MD,  PhD*  

*Consultancy and research support – GE Vingmed, TomTec Imaging Systems

•  Good image quality

•  Anatomic rendering

•  Better diagnostic yield

•  Unprecedented

quantitation

•  Monitoring procedures

3D Echo scanner

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•  31-year-old woman •  MV “incidentaloma” at

transthoracic echo •  Sent for TEE

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Rapid solving of unclear structures

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Biplane imaging using the matrix probe

Realis>c  in  vivo  anatomy  

Atrial perspective (“surgical view”) Ventricular perspective

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Increased  Diagnos>c  Yield  –  “Surgeon’s  View”  

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-  73 year-old man -  severe organic MR - evaluation for percutaneous Neochord implantation

LAA

Ao

Improved  quality  of  challenging  structures  

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Anatomical  Details  

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Virtual  Anatomy  and  Quan>ta>on  at  Pa>ent  Bedside

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New  Features  during  Postprocessing  for  Enhancing  Anatomical  Details  

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PiSalls  of  MV  Area  Planimetry  by  2D  Echo  

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Assessing Mitral Stenosis Severity

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Assessing Mitral Stenosis Severity

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Mitral Stenosis Severity

Rheuma>c  MV  disease:  evalua>on  for  PMBC  indica>on  

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3DTEE-Guided PMBC

Ao  

LAA  

IAS  

TV  

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Anatomical  details  of  LAA  

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Tricuspid  Regurgita>on:  Which  Mechanism?  

TRV max = 2.8 m/s

•  76 year-old lady •  Sclerodermia •  Pacemaker implantation 10 months before •  Known moderate TR •  Admitted for decompensated right heart failure

3DE  IN  VALVULAR  HEART  DISEASE  

Tricuspid  Regurgita>on:  Which  Mechanism?  

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Tricuspid  Regurgita>on:  No  Pacemaker  Interference  

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Tricuspid  Regurgita>on:  a[er  1  week  of  diure>cs  

TRV max = 3.8 m/s

3D PRINTING OF TRICUSPID VALVE USING 3DTTE

Muraru D et al. ESC 2015

Total time for generating the 3D model of TV was 30 min

•  The tangible 3D model of TV

enhanced the perception of the complex 3D shape of the TV and of the non-planarity of TV annulus

3D PRINTING OF TRICUSPID VALVE USING 3DTTE

•  This technique could be potentially integrated in clinical practice to assist the

surgical planning and education, and the simulation of the outcomes of various percutaneus TV interventions

Muraru D et al. ESC 2015; EuroEcho 2015

Anatomy  and  Flow  

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When  Color  Ma]ers  

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Assessing outcome after valve procedures

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Assessing outcome after valve procedures

•  75 year-old lady •  percutaneous closure of periprosthetic leak 6 months before •  dyspnea at minimal exertion •  haemolysis

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Perivalvular leak after device closure

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Perivalvular leak after device closure

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Other “side-effects” after device closure

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Other “side-effects” after device closure

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Other “side-effects” after device closure

Assessing  Outcome  of  Interven>onal  Procedures

Clinical case courtesy of Dr. Monica Alcantara

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Thank you for your attention!