Complex and multilevel left ventricular outflow tract obstruction: What can 3D echocardiography add?

Background Subaortic obstruction by a membrane or systolic anterior motion of the mitral valve leaflets is usually suspected in young patients, especially if the anatomy of the aortic valve is not clearly stenotic and unexplained left ventricular hypertrophy exists in the context of high transaortic...

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Bibliographic Details
Published in:The Egyptian heart journal 2021-08, Vol.73 (1), p.73-73, Article 73
Main Authors: Abdelgawad, Hoda, Shehata, Mahmoud, Abdelnabi, Mahmoud, Almaghraby, Abdallah, Abdel-Hay, Mohamed Ayman
Format: Article
Language:English
Subjects:
3D echocardiography
Aortic stenosis
Aortic valve stenosis
Cardiology
Commentary
Consent
Coronary vessels
Echocardiography
Heart enlargement
Left ventricular outflow tract obstruction
Localization
Medicine
Medicine & Public Health
Mitral valve stenosis
Subaortic membrane
Surgeons
Xenotransplantation
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Summary:Background Subaortic obstruction by a membrane or systolic anterior motion of the mitral valve leaflets is usually suspected in young patients, especially if the anatomy of the aortic valve is not clearly stenotic and unexplained left ventricular hypertrophy exists in the context of high transaortic gradients. Main body In certain circumstances, some patients show both aortic and subaortic stenotic lesions of variable severity. Doppler echocardiography can help in grading severity in the case of single-level obstruction but not in patients with multilevel obstruction where the continuity equation is of no value. Three-dimensional (3D) echocardiography allows "en-face" visualization of each level of the aortic valve and subaortic tract; in addition, direct planimetry of the areas can be done using multiplanar reformatting. Conclusions Accordingly, 3D echocardiography plays a crucial role in the assessment in patients with multilevel left ventricular outflow tract obstruction as it can accurately delineate the location and size, and severity of the stenosis.
ISSN:2090-911X
1110-2608
2090-911X
DOI:10.1186/s43044-021-00197-y