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3d Echocardiography

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3D echocardiography Workshop Advanced Echo 2015 Jim Newton 12:24 The Menu Start 3D guidelines Measuring EF Types of 3D echo Why is there MR? 3D echo saves you time 3D is more accurate 3D is not perfect 3D in planning surgery Heart failure – why? What 3D echo cannot do Future of 3D echo? Risks of 3D echo Ad Break 1 Your view of 3D echo 1. No kit and therefore no experience 2. Have the kit but don’t see the point 3. Have tried it but never found it helpful 4. Increasing my use of 3D 5. Use it all the time What happens next? This... What happens next? What happens next? What happens next? Best 2D methods Best 2D methods Why do we need accurate TTE? 3D LVEF As good as CMR? r=0.88 Vannan et al. JACC imaging 2012:5;239-251 Real world data Does 3D save the day? 3D for EF needs contrast 3D echo modes Real time Live 3D Multi-beat Full volume Biplane imaging Live 3D colour 3D zoom Other Full volume Colour Live 3D echo 3D zoom mode 3D zoom mode Full volume (multi-beat) Full volume Full volume artefacts Biplane imaging Why is there MR? Why is there MR? Why is there MR? Why is there MR? Tethered posterior leaflet Why is there MR? Commissural prolapse Why is there MR? View structures ‘en-face’ MR through cleft repair site Speed up workflow? Speed up workflow? Speed up workflow? Speed up workflow? 3D is more accurate Increase accuracy of measurements Increase accuracy of measurements 3D TOE MPR planimetry Best practice Surgical planning Surgical planning Exact pathophysiology 3D in complex anatomy 3D in complex anatomy 3D in complex anatomy 3D pitfalls and challenges 3D pitfalls and challenges 3D pitfalls and challenges 3D pitfalls and challenges 3D pitfalls and challenges 3D pitfalls and challenges Guideline now released Heart Failure – why? Heart failure – why? Normal bioprosthesis Normal and abnormal Normal vs. abnormal What happens next? This... 3D colour – field of view Atrial fibrillation 3D good for en-face structures Dropout Dropout Dropout Dropout? Wide field of view Risks of 3D TOE