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Feasibility and Effectiveness of Three-Dimensional Echocardiography in Diagnosing Congenital Heart Diseases


Three-dimensional echocardiography (3DE), a novel approach employed in detecting congenital heart disease (CHD), has gained popularity since it was made commercially available in 2002. This modality is now accepted as an important diagnostic tool for diagnosing CHD. Advancement in transducer technologies and digital data processing allows the use of 3DE in daily clinical practice. In this review, modes of 3DE data acquisition and storage methods in the echocardiogram’s machine’s hard disk (data processing) are examined. Analysis of the acquired data (cropping or slicing the data set) and methods of illustrating the cropped data set for cardiologists and pediatric cardiovascular surgeons are also discussed. Published literature was searched in PubMed using the keywords “three-dimensional echocardiography”, “congenital heart disease”, “cropping”, and “echoangiogram”. This search produced 100 articles, which were further short-listed to 30 articles. Based on this algorithm, the final selected 30 articles were extensively examined in the current review. The clinical applications of real-time transthoracic 3DE, as well as novel transesophageal 3DE and color flow 3DE data set analyses (echoangiogram) in the routine practice of CHD assessment, are also reviewed. Finally, the limitations 3DE, together with the potential future developments required to improve various techniques of 3DE to make it more readily applicable, are examined.

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Correspondence to Saad. Khoshhal.

Electronic Supplementary Material

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Movie Clip 1

RT 3DE in NA mode showing the MV, the LV in long-axis view, and the aortic valve, similar to 2D PSLAx (AVI 3255 kb)

Movie Clip 2

Zoom mode (magnified) shows the aortic valve from a view above the valve (i.e., within the ascending aorta) (AVI 757 kb)

Movie Clip 3

Acquired FV 3DE data set. The details of cardiac anatomy are embedded within this data set and thus incomprehensible until cropping is performed (AVI 2598 kb)

Movie Clip 4

Content within the FV 3DE data set shown in Movie Clip 3. The four cardiac chambers are visualized in this image, similar to an apical four-chamber view (AVI 1455 kb)

Movie Clip 5

3DE of a cleft mitral valve as seen from the LA, which is identical to what is seen by the surgeon during surgery (i.e., surgical view) (AVI 646 kb)

Movie Clip 6

RTTE-3DE. The ASD is seen from the LA (AVI 645 kb)

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Khoshhal, S. Feasibility and Effectiveness of Three-Dimensional Echocardiography in Diagnosing Congenital Heart Diseases. Pediatr Cardiol 34, 1525–1531 (2013).

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