Real time 3-D echocardiography in cardiac surgery

Objective: Real time 3-D echocardiography provides real time live images of intracardiac anatomy. We evaluate its clinical application for intraoperative echocardiography. Method: The "xStream"3-D architecture designed with "xMatrix array" using approximately 3,000 transducer elements achieves live digital volume imaging in real time 3-D echocardiography (SONOS 7500, Philips Medical Systems, Inc.). Intraoperative echocardiography was performed in mitral (n=14) and aortic valve diseases (n=6), 4 heart anomaly, 4 aortic diseases and 15 normal anatomies. Results: Heart valves were depicted via enface view. Simultaneous movement of leaflets and subvalvular apparatus can be observed. Prolapsed leaflets are easily detected and regurgitated jets are detected as 3-D color images. The four cardiac chambers were observed in their real shape and size. Septum defects were also depicted in real shape, size and position. Precise intracardiac anatomy was observed in cardiac anomalies. Information on the endothelium, intimal flap, entry, reentry and aortic wall character was provided and allowed for planning in aortic surgery. Conclusion: Live 3-D echocardiography provides excellent depiction of any cardiac and aortic anatomy in any direction and greatly enhances efficiencies in planning appropriate surgical procedures.