Feasibility of measurements of valve dimensions in en-face-3D transesophageal echocardiography

  • Sarah Eibel
  • Edwin Turton
  • Chirojit Mukherjee
  • Carmine Bevilacqua
  • Joerg Ender
Original Paper


Newest 3D software allows measurements directly in the en-face-3D TEE mode. Aim of the study was to ascertain whether measurements performed in the en-face-3D TEE mode are comparable with conventional measurement methods based on 2D TEE and 3D using the multiple plane reconstruction mode with the Qlab® software. En-face-3D TEE is used more frequently in daily clinical routine during cardiac operations. So far measurements could only be done based on 2D images or with the use of multi planar reconstruction mode with additional software. Measurement directly in the 3D image (en-face-3D TEE) would make measurements faster and easier to use in clinical practice. After approval by the local ethic committee and written informed consent from the patients additionally to a comprehensive perioperative 2D TEE examination a real time (RT) 3D zoom- dataset was recorded. Routine measurements of the length of anterior and posterior mitral valve leaflets as well as mitral valve and aortic valve areas were performed in en-face-3D TEE, multiplanar reconstruction mode using Qlab®-software (Philips, Netherlands) and 2D TEE standard views. Twenty nine patients with a mean age of 67 years undergoing elective cardiac surgery/interventions were enrolled in this study. Direct measurements in en-face-3D TEE mode lead to non significant underestimation of all parameters as compared to Qlab® and 2D TEE measurements. Measurements in en-face-3D TEE are feasible but lead to non significant underestimation compared to measurements performed with Qlab® or in 2D TEE views.


En-face-3D TEE RT 3D TEE 2D TEE Heart valve disease Intraoperative 3D imaging 



Chamber view


Transesophageal echocardiography


Two dimensional


Three dimensional


Real time


Aortic valve


Mitral valve


Anterior mitral leaflet


Posterior mitral leaflet


Aortic valve area


Mitral valve area




Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

After approval by the local ethics committee and written informed consent was received, 29 patients undergoing elective cardiac surgery and interventional cardiac procedures were enrolled in this study. This study has been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.


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Copyright information

© Springer Science+Business Media Dordrecht 2017

Authors and Affiliations

  • Sarah Eibel
    • 1
  • Edwin Turton
    • 3
  • Chirojit Mukherjee
    • 2
  • Carmine Bevilacqua
    • 3
  • Joerg Ender
    • 3
  1. 1.Department of AnesthesiologyUniversity Medical Center of the Johannes-Gutenberg UniversityMainzGermany
  2. 2.Department of Anesthesia and Intensive CareClinic for Cardiac SurgeryKarlsruheGermany
  3. 3.Department of Anesthesiology and Intensive Care MedicineHeart Center LeipzigLeipzigGermany

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