New insights and observations in three-dimensional echocardiographic visualization of ventricular septal defects: Experimental and clinical studies

Richard Kardon, Qi Ling Cao, Navroz Masani, Lissa Sugeng, Stacey Supran, Kenneth G. Warner, Natesa G. Pandian, Gerald R. Marx

Research output: Contribution to journalArticle

39 Citations (Scopus)

Abstract

Background - The positions, sizes, and shapes of ventricular septal defects (VSDs) can be difficult to assess by 2-dimensional echocardiography (2DE). Volume-rendered 3-dimensional echocardiography (3DE) can provide unique views of VSDs from the left ventricular (LV) side, allowing complete assessment of their circumference and spatial orientations to other anatomic structures. Methods and Results - Seventeen experimentally created defects of various locations, sizes, and shapes were imaged and reconstructed in 9 explanted porcine hearts. From an en face projection, major and minor axis diameters of the defects were measured, and these data were compared with direct anatomic measurements. Optimal reconstructions of the VSDs were obtained in all heart specimens, accurately depicting their positions and shapes. The correlations between 3DE and anatomy for the VSD major and minor axis diameters were y=1.0x+0.3 (r=0.88, P<0.001) and y=1.0x-1.4 (r=0.89, P<0.001), respectively. Good agreement between the 2 methods was demonstrated for all measurements. Our experience from the in vitro model was then applied to patient studies. Optimal LV en face reconstructions were obtained in 45 of 51 patients, permitting detailed assessment of the positions, sizes, and shapes of the VSDs. In the 25 patients with comparative surgical measurements, the correlations between 3DE and surgery for the VSD major and minor axis diameters were y=0.81x+2.1 (r=0.92, P<0.001) and y=0.73x+2.0 (r=0.91, P<0.001), respectively. Good agreement was demonstrated between measurements made by 3DE and those obtained at surgery. Conclusions - 3DE provides excellent visualization of various types of VSDs. From an LV en face projection, the positions, sizes, and shapes of VSDs can be accurately determined. Such precise imaging will be beneficial for surgical and catheter-based closure of difficult perimembranous and singular or multiple muscular VSDs.

Original languageEnglish
Pages (from-to)1307-1314
Number of pages8
JournalCirculation
Volume98
Issue number13
StatePublished - Sep 29 1998
Externally publishedYes

Fingerprint

Ventricular Heart Septal Defects
Echocardiography
Clinical Studies
Anatomy
Swine
Catheters

Keywords

  • Echocardiography
  • Heart septal defects
  • Pediatrics

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Kardon, R., Cao, Q. L., Masani, N., Sugeng, L., Supran, S., Warner, K. G., ... Marx, G. R. (1998). New insights and observations in three-dimensional echocardiographic visualization of ventricular septal defects: Experimental and clinical studies. Circulation, 98(13), 1307-1314.

New insights and observations in three-dimensional echocardiographic visualization of ventricular septal defects : Experimental and clinical studies. / Kardon, Richard; Cao, Qi Ling; Masani, Navroz; Sugeng, Lissa; Supran, Stacey; Warner, Kenneth G.; Pandian, Natesa G.; Marx, Gerald R.

In: Circulation, Vol. 98, No. 13, 29.09.1998, p. 1307-1314.

Research output: Contribution to journalArticle

Kardon, R, Cao, QL, Masani, N, Sugeng, L, Supran, S, Warner, KG, Pandian, NG & Marx, GR 1998, 'New insights and observations in three-dimensional echocardiographic visualization of ventricular septal defects: Experimental and clinical studies', Circulation, vol. 98, no. 13, pp. 1307-1314.
Kardon, Richard ; Cao, Qi Ling ; Masani, Navroz ; Sugeng, Lissa ; Supran, Stacey ; Warner, Kenneth G. ; Pandian, Natesa G. ; Marx, Gerald R. / New insights and observations in three-dimensional echocardiographic visualization of ventricular septal defects : Experimental and clinical studies. In: Circulation. 1998 ; Vol. 98, No. 13. pp. 1307-1314.
@article{6a11ec0eb1664d61824c25ad811e40af,
title = "New insights and observations in three-dimensional echocardiographic visualization of ventricular septal defects: Experimental and clinical studies",
abstract = "Background - The positions, sizes, and shapes of ventricular septal defects (VSDs) can be difficult to assess by 2-dimensional echocardiography (2DE). Volume-rendered 3-dimensional echocardiography (3DE) can provide unique views of VSDs from the left ventricular (LV) side, allowing complete assessment of their circumference and spatial orientations to other anatomic structures. Methods and Results - Seventeen experimentally created defects of various locations, sizes, and shapes were imaged and reconstructed in 9 explanted porcine hearts. From an en face projection, major and minor axis diameters of the defects were measured, and these data were compared with direct anatomic measurements. Optimal reconstructions of the VSDs were obtained in all heart specimens, accurately depicting their positions and shapes. The correlations between 3DE and anatomy for the VSD major and minor axis diameters were y=1.0x+0.3 (r=0.88, P<0.001) and y=1.0x-1.4 (r=0.89, P<0.001), respectively. Good agreement between the 2 methods was demonstrated for all measurements. Our experience from the in vitro model was then applied to patient studies. Optimal LV en face reconstructions were obtained in 45 of 51 patients, permitting detailed assessment of the positions, sizes, and shapes of the VSDs. In the 25 patients with comparative surgical measurements, the correlations between 3DE and surgery for the VSD major and minor axis diameters were y=0.81x+2.1 (r=0.92, P<0.001) and y=0.73x+2.0 (r=0.91, P<0.001), respectively. Good agreement was demonstrated between measurements made by 3DE and those obtained at surgery. Conclusions - 3DE provides excellent visualization of various types of VSDs. From an LV en face projection, the positions, sizes, and shapes of VSDs can be accurately determined. Such precise imaging will be beneficial for surgical and catheter-based closure of difficult perimembranous and singular or multiple muscular VSDs.",
keywords = "Echocardiography, Heart septal defects, Pediatrics",
author = "Richard Kardon and Cao, {Qi Ling} and Navroz Masani and Lissa Sugeng and Stacey Supran and Warner, {Kenneth G.} and Pandian, {Natesa G.} and Marx, {Gerald R.}",
year = "1998",
month = "9",
day = "29",
language = "English",
volume = "98",
pages = "1307--1314",
journal = "Circulation",
issn = "0009-7322",
publisher = "Lippincott Williams and Wilkins",
number = "13",

}

TY - JOUR

T1 - New insights and observations in three-dimensional echocardiographic visualization of ventricular septal defects

T2 - Experimental and clinical studies

AU - Kardon, Richard

AU - Cao, Qi Ling

AU - Masani, Navroz

AU - Sugeng, Lissa

AU - Supran, Stacey

AU - Warner, Kenneth G.

AU - Pandian, Natesa G.

AU - Marx, Gerald R.

PY - 1998/9/29

Y1 - 1998/9/29

N2 - Background - The positions, sizes, and shapes of ventricular septal defects (VSDs) can be difficult to assess by 2-dimensional echocardiography (2DE). Volume-rendered 3-dimensional echocardiography (3DE) can provide unique views of VSDs from the left ventricular (LV) side, allowing complete assessment of their circumference and spatial orientations to other anatomic structures. Methods and Results - Seventeen experimentally created defects of various locations, sizes, and shapes were imaged and reconstructed in 9 explanted porcine hearts. From an en face projection, major and minor axis diameters of the defects were measured, and these data were compared with direct anatomic measurements. Optimal reconstructions of the VSDs were obtained in all heart specimens, accurately depicting their positions and shapes. The correlations between 3DE and anatomy for the VSD major and minor axis diameters were y=1.0x+0.3 (r=0.88, P<0.001) and y=1.0x-1.4 (r=0.89, P<0.001), respectively. Good agreement between the 2 methods was demonstrated for all measurements. Our experience from the in vitro model was then applied to patient studies. Optimal LV en face reconstructions were obtained in 45 of 51 patients, permitting detailed assessment of the positions, sizes, and shapes of the VSDs. In the 25 patients with comparative surgical measurements, the correlations between 3DE and surgery for the VSD major and minor axis diameters were y=0.81x+2.1 (r=0.92, P<0.001) and y=0.73x+2.0 (r=0.91, P<0.001), respectively. Good agreement was demonstrated between measurements made by 3DE and those obtained at surgery. Conclusions - 3DE provides excellent visualization of various types of VSDs. From an LV en face projection, the positions, sizes, and shapes of VSDs can be accurately determined. Such precise imaging will be beneficial for surgical and catheter-based closure of difficult perimembranous and singular or multiple muscular VSDs.

AB - Background - The positions, sizes, and shapes of ventricular septal defects (VSDs) can be difficult to assess by 2-dimensional echocardiography (2DE). Volume-rendered 3-dimensional echocardiography (3DE) can provide unique views of VSDs from the left ventricular (LV) side, allowing complete assessment of their circumference and spatial orientations to other anatomic structures. Methods and Results - Seventeen experimentally created defects of various locations, sizes, and shapes were imaged and reconstructed in 9 explanted porcine hearts. From an en face projection, major and minor axis diameters of the defects were measured, and these data were compared with direct anatomic measurements. Optimal reconstructions of the VSDs were obtained in all heart specimens, accurately depicting their positions and shapes. The correlations between 3DE and anatomy for the VSD major and minor axis diameters were y=1.0x+0.3 (r=0.88, P<0.001) and y=1.0x-1.4 (r=0.89, P<0.001), respectively. Good agreement between the 2 methods was demonstrated for all measurements. Our experience from the in vitro model was then applied to patient studies. Optimal LV en face reconstructions were obtained in 45 of 51 patients, permitting detailed assessment of the positions, sizes, and shapes of the VSDs. In the 25 patients with comparative surgical measurements, the correlations between 3DE and surgery for the VSD major and minor axis diameters were y=0.81x+2.1 (r=0.92, P<0.001) and y=0.73x+2.0 (r=0.91, P<0.001), respectively. Good agreement was demonstrated between measurements made by 3DE and those obtained at surgery. Conclusions - 3DE provides excellent visualization of various types of VSDs. From an LV en face projection, the positions, sizes, and shapes of VSDs can be accurately determined. Such precise imaging will be beneficial for surgical and catheter-based closure of difficult perimembranous and singular or multiple muscular VSDs.

KW - Echocardiography

KW - Heart septal defects

KW - Pediatrics

UR - http://www.scopus.com/inward/record.url?scp=0344878898&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0344878898&partnerID=8YFLogxK

M3 - Article

C2 - 9751680

AN - SCOPUS:0344878898

VL - 98

SP - 1307

EP - 1314

JO - Circulation

JF - Circulation

SN - 0009-7322

IS - 13

ER -