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Aortic Regurgitation

  • Sorina Mihaila Baldea
  • Dragos Vinereanu
  • Luigi P. Badano
Chapter

Abstract

Conventional two-dimensional and Doppler echocardiography (2DE) are widely used to establish the pathophysiology and to assess the severity of aortic regurgitation. However, due to its tomographic nature, 2DE has important limitations to appreciate the geometry and the dynamics of the aortic valve complex. Conversely, three-dimensional echocardiography (3DE) can assess the aortic valve complex without geometrical assumptions about the shape of its different components and offer unprecedented, anatomically sound, images of the aortic valve.

The different components of the aortic valve complex can be visualized from any perspective using a single acquired full-volume data set allowing a complete understanding of their anatomy and function. The following chapter describes the additional value of 3DE over 2DE for the assessment of patients with aortic valve regurgitation, with respect to etiology, mechanisms and severity of the disease, as well as planning of future procedures.

Keywords

Aortic regurgitation Three-dimensional echocardiography Transesophageal Transthoracic Aortic valve morphology Aortic regurgitation severity 

References

  1. 1.
    Badano LP, Boccalini F, Muraru D, Bianco LD, Peluso D, Bellu R, et al. Current clinical applications of transthoracic three-dimensional echocardiography. J Cardiovasc Ultrasound. 2012;20(1):1–22.CrossRefGoogle Scholar
  2. 2.
    Lang RM, Mor-Avi V, Sugeng L, Nieman PS, Sahn DJ. Three-dimensional echocardiography: the benefits of the additional dimension. J Am Coll Cardiol. 2006;48(10):2053–69.CrossRefGoogle Scholar
  3. 3.
    Muraru D, Badano LP, Vannan M, Iliceto S. Assessment of aortic valve complex by three-dimensional echocardiography: a framework for its effective application in clinical practice. Eur Heart J Cardiovasc Imaging. 2012;13(7):541–55.CrossRefGoogle Scholar
  4. 4.
    Mahmood F, Warraich HJ, Gorman JH 3rd, Gorman RC, Chen TH, Panzica P, et al. Changes in mitral annular geometry after aortic valve replacement: a three-dimensional transesophageal echocardiographic study. J Heart Valve Dis. 2012;21(6):696–701.PubMedPubMedCentralGoogle Scholar
  5. 5.
    Veronesi F, Caiani EG, Sugeng L, Fusini L, Tamborini G, Alamanni F, et al. Effect of mitral valve repair on mitral-aortic coupling: a real-time three-dimensional transesophageal echocardiography study. J Am Soc Echocardiogr. 2012;25(5):524–31.CrossRefGoogle Scholar
  6. 6.
    Joint Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology, European Association for Cardio-Thoracic Surgery, Vahanian A, Alfieri O, Andreotti F, Antunes MJ, et al. Guidelines on the management of valvular heart disease (version 2012). Eur Heart J. 2012;33(19):2451–96.CrossRefGoogle Scholar
  7. 7.
    Lang RM, Tsang W, Weinert L, Mor-Avi V, Chandra S. Valvular heart disease. The value of 3-dimensional echocardiography. J Am Coll Cardiol. 2011;58(19):1933–44.CrossRefGoogle Scholar
  8. 8.
    Sadron Blaye-Felice MA, Seguela PE, Arnaudis B, Dulac Y, Lepage B, Acar P. Usefulness of three-dimensional transthoracic echocardiography for the classification of congenital bicuspid aortic valve in children. Eur Heart J Cardiovasc Imaging. 2012;13(12):1047–52.CrossRefGoogle Scholar
  9. 9.
    Espinola-Zavaleta N, Munoz-Castellanos L, Attie F, Hernandez-Morales G, Zamora-Gonzalez C, Duenas-Carbajal R, et al. Anatomic three-dimensional echocardiographic correlation of bicuspid aortic valve. J Am Soc Echocardiogr. 2003;16(1):46–53.CrossRefGoogle Scholar
  10. 10.
    Burri MV, Nanda NC, Singh A, Panwar SR. Live/real time three-dimensional transthoracic echocardiographic identification of quadricuspid aortic valve. Echocardiography. 2007;24(6):653–5.CrossRefGoogle Scholar
  11. 11.
    Longobardo L, Coluccia V, Azzu A, Scarfo IS, Alfieri O, La Canna G. Three-dimensional echocardiography diagnosis of double perforation of bicuspid aortic valve. J Cardiovasc Med (Hagerstown). 2017;18(10):841–2.CrossRefGoogle Scholar
  12. 12.
    Szymanski T, Maslow A, Mahmood F, Singh A. Three-dimensional echocardiographic assessment of coaptation after aortic valve repair. J Cardiothorac Vasc Anesth. 2017;31(3):993–1000.CrossRefGoogle Scholar
  13. 13.
    Nemes A, Lagrand WK, McGhie JS, ten Cate FJ. Three-dimensional transesophageal echocardiography in the evaluation of aortic valve destruction by endocarditis. J Am Soc Echocardiogr. 2006;19(3):355 e13–4.CrossRefGoogle Scholar
  14. 14.
    Veronesi F, Corsi C, Sugeng L, Mor-Avi V, Caiani EG, Weinert L, et al. A study of functional anatomy of aortic-mitral valve coupling using 3D matrix transesophageal echocardiography. Circ Cardiovasc Imaging. 2009;2(1):24–31.CrossRefGoogle Scholar
  15. 15.
    Khosravi A, Sheykhloo H, Karbasi-Afshar R, Saburi A. Echocardiographic changes after aortic valve replacement: Does the failure rate of mitral valve change? ARYA Atheroscler. 2015;11(2):147–52.PubMedPubMedCentralGoogle Scholar
  16. 16.
    Shiota T, Jones M, Delabays A, Li X, Yamada I, Ishii M, et al. Direct measurement of three-dimensionally reconstructed flow convergence surface area and regurgitant flow in aortic regurgitation: in vitro and chronic animal model studies. Circulation. 1997;96(10):3687–95.CrossRefGoogle Scholar
  17. 17.
    Fang L, Hsiung MC, Miller AP, Nanda NC, Yin WH, Young MS, et al. Assessment of aortic regurgitation by live three-dimensional transthoracic echocardiographic measurements of vena contracta area: usefulness and validation. Echocardiography. 2005;22(9):775–81.CrossRefGoogle Scholar
  18. 18.
    Mori Y, Shiota T, Jones M, Wanitkun S, Irvine T, Li X, et al. Three-dimensional reconstruction of the color Doppler-imaged vena contracta for quantifying aortic regurgitation: studies in a chronic animal model. Circulation. 1999;99(12):1611–7.CrossRefGoogle Scholar
  19. 19.
    Li X, Jones M, Irvine T, Rusk RA, Mori Y, Hashimoto I, et al. Real-time 3-dimensional echocardiography for quantification of the difference in left ventricular versus right ventricular stroke volume in a chronic animal model study: improved results using C-scans for quantifying aortic regurgitation. J Am Soc Echocardiogr. 2004;17(8):870–5.CrossRefGoogle Scholar
  20. 20.
    Chin CH, Chen CH, Lo HS. The correlation between three-dimensional vena contracta area and aortic regurgitation index in patients with aortic regurgitation. Echocardiography. 2010;27(2):161–6.CrossRefGoogle Scholar
  21. 21.
    Grady L, Datta S, Kutter O, Duong C, Wein W, Little SH, et al. Regurgitation quantification using 3D PISA in volume echocardiography. Med Image Comput Comput Assist Interv. 2011;14(Pt 3):512–9.PubMedGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Sorina Mihaila Baldea
    • 1
    • 2
  • Dragos Vinereanu
    • 1
    • 2
  • Luigi P. Badano
    • 3
  1. 1.The University of Medicine and Pharmacy Carol DavilaBucharestRomania
  2. 2.Department of CardiologyEmergency University Hospital BucharestBucharestRomania
  3. 3.University of Milano-Bicocca, and Istituto Auxologico Italiano, IRCCS, San Luca HospitalMilanoItaly

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