Clinical Applications of Three-Dimensional Transesophageal Echocardiography in Congenital Heart Disease

  • Vivian Wei Cui
  • David A. RobersonEmail author


In this chapter we present a collection of three-dimensional (3D) transesophageal echocardiographic images from scenarios and cases that constitute representative examples of the useful clinical application of this technique to patients with congenital heart disease (CHD). Four general areas of discussion include: (1) 3D anatomic assessment; (2) use during interventional catheterization; (3) imaging of representative surgical treatments; and (4) applications related to electrophysiologic issues. Acquisitions using live 3D, 3D zoom, full volume 3D, X-plane and 3D color modalities are included. Suggestions for the choice of acquisition modality and image optimization are made for various imaging scenarios. The recommendations in this chapter are based largely on personal experience and preferences gained from performing 3D TEE in over 400 patients with CHD. We hope the reader will find this information useful and prompt further training, practice, more widespread use, and investigation of the applications of 3D TEE in CHD.


Three-dimensional echocardiography 3D Transesophageal echocardiography Real-time 3D transesophageal echocardiography 3D Image acquisition modalities 3D Full volume 3D Live 3D Zoom X-Plane 3D Color mode Congenital heart disease 

Supplementary material (216 kb)
Video 20.1 Full volume 3D acquisition in a mid esophageal four chamber view obtained in a patient with cor triatriatum, dextrocardia and multiple ventricular septal defects. The cor triatriatum membrane divides the left atrium into proximal and distal chambers (MOV 215 kb) (182 kb)
Video 20.2 3D color Doppler flow map obtained in the same patient displayed in Video 20.1 demonstrates turbulent flow through the cor triatriatum obstructive orifice from a posterior view (MOV 182 kb)
Video 20.3

Live 3D mid esophageal aortic valve short axis acquisition from a patient with a bicuspid aortic valve due to left and right leaflet fusion (MOV 1048 kb)

Video 20.4

Live 3D mid esophageal aortic valve short axis acquisition from a patient with a bicuspid aortic valve due to right and non-coronary leaflet fusion (MOV 667 kb)

Video 20.5

Full volume 3D mid esophageal four chamber view of the hypoplastic and doming parachute mitral valve (MOV 695 kb) (166 kb)
Video 20.6 Live 3D color Doppler flow mapping image of muscular ventricular septal defect from a mid esophageal long axis view (MOV 165 kb) (319 kb)
Video 20.7 Perimembranous ventricular septal defect as seen from a mid esophageal four chamber view with slight rightward rotation using full volume 3D acquisition (MOV 318 kb)
Video 20.8

Multiple orifice secundum atrial septal defect obtained from a mid esophageal four chamber view using 3D zoom mode. A thin vertical band of septum primum divides the ASD into a large anterior orifice and small posterior orifice (MOV 273 kb)

Video 20.9

View of an Amplatzer device as seen from a deep transgastric modified view acquired using live 3D (MOV 180 kb) (238 kb)
Video 20.10 Full volume 3D acquisition showing a muscular ventricular septal defect device after transcatheter device closure. The images were obtained from the mid esophageal four chamber view (MOV 238 kb)
Video 20.11

Live 3D acquisition from the mid esophageal long axis view demonstrating dehiscence of a bicuspid aortic valve leaflet augmentation repair in a patient with endocarditis. The leaflet augmentation material oscillates between the left ventricular outflow tract and aorta (MOV 777 kb) (316 kb)
Video 20.12 Mid esophageal aortic valve long axis full volume 3D acquisition of a Konno procedure and aortic valve replacement using a bioprosthetic valve. The ventricular septal defect patch and bioprosthetic aortic valve are demonstrated (MOV 316 kb)
Video 20.13

Mid esophageal short axis full volume 3D acquisition of a Konno procedure and aortic valve replacement using a bioprosthetic valve. The bioprosthetic aortic valve is seen (MOV 297 kb) (176 kb)
Video 20.14 Mid esophageal four chamber view acquired using full volume 3D from a patient with D-transposition of the great arteries, after a Mustard procedure. The systemic and pulmonary venous baffles are seen (MOV 176 kb)
Video 20.15

Deep transgastric live 3D acquisition from a patient with D-transposition of the great arteries after a Mustard procedure demonstrating stenosis in the left ventricular outflow tract beneath the pulmonary valve (MOV 247 kb)

Video 20.16

Three-dimensional image in a patient with a ‘classic’ Fontan operation (atriopulmonary connection) displaying an organized thrombus within the Fontan connection (MOV 419 kb)

Video 20.17

Image in a patient with a classic Fontan operation demonstrating with very dense spontaneous contrast (sludge) (MOV 206 kb) (342 kb)
Video 20.18 Transgastric mid short axis live 3D view in a patient with hypertrophic cardiomyopathy demonstrating the hypertrophied left ventricle and a pericardial effusion after defibrillator lead perforation of the right ventricle. The lead is well seen in the pericardial space (MOV 342 kb)


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Copyright information

© Springer-Verlag London 2014

Authors and Affiliations

  1. 1.Division of Pediatric Cardiology, Department of PediatricsAdvocate Children’s Hospital Heart InstituteOak LawnUSA

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