Assesment with three dimensional TEE
In order to obtain values of mitral valve parameters before CRT implantation, real time 3 dimensional transesophageal echocardiography (TEE) Vivid 9 Ultrasound system was used. Using TEE probe in mid-esophageal position at full volume and in real time zoom mode with long axis view from left atrial perspective, images including mitral valve, aorta and LAA (left atrial appendix) and equivalent to surgical view were obtained. In order to increase temporal resolution multibeat images (at least 4 beat) (Frame rate: 8-12 Hz) in the region of interest, distance between sectors was decreased and gain was optimized to evaluate valve anatomy clearly and prevent artifacts. (Figure1)
Figure 1: .Evaluation of mitral valve apparatus with 3 dimensional transosephageal echocardiography
Data obtained in 3D zoom mode were recorded with EchoPac PC Software, Version 6.3 (GE Vingmed US, Horten, Norway), performing semi automated analysis. Detailed measurments of mitral valve was accessed with 4D MVQ (Mitral Valve Quantification, GE Healthcare) program automatically and data were anlysed in offline mode. (Figure 2)
Figure 2: Three dimensional evaluation of mitral valve with EchoPac PC Software 4D MVQ program automatically