Mohammed J. Arisha

Usefulness of three-dimensional echocardiography in the assessment of valvular involvement in Loeffler endocarditis

Loeffler endocarditis is a complication of hypereosinophilic syndrome resulting from eosinophilic infiltration of heart tissue. We report a case of Loeffler endocarditis in which three‐dimensional transthoracic and transesophageal echocardiography provided additional information to what was found by two‐dimensional transthoracic echocardiography alone. Our case illustrates the usefulness of combined two‐ and three‐dimensional echocardiography in the assessment of Loeffler endocarditis. In addition, a summary of the features of hypereosinophilic syndrome and Loeffler endocarditis is provided in tabular form.

Usefulness of two- and three-dimensional transesophageal echocardiography in combined mitral valve-in-valve implantation and paraprosthetic leak closure

We demonstrate the usefulness of two‐ and live/real time three‐dimensional transesophageal echocardiography in a procedure, which combined transcatheter mitral valve‐in‐valve deployment and paraprosthetic leak closure in the same setting using the less invasive transfemoral approach in an adult patient with bioprosthetic mitral valve degeneration. We also highlight the additive value of three‐dimensional echocardiography over the two‐dimensional technique.

Incremental benefit of three-dimensional transthoracic echocardiography in the assessment of left atrial appendage aneurysm leading to severe extrinsic compression of a coronary artery

Left atrial appendage aneurysm (LAA AN) is a rare disease entity, which can be congenital or acquired in nature. We report an adult patient with LAA AN presenting with anginal chest pain in whom live/real time three‐dimensional transthoracic echocardiography (3DTTE) provided incremental value over the two‐dimensional (2D) technique in providing a more comprehensive assessment of the lesion. A literature review of the salient features of LAA AN is also provided in a tabular form.

Three-dimensional transesophageal echocardiography is an attractive alternative to cardiac multi-detector computed tomography for aortic annular sizing: Systematic review and meta-analysis

Cardiac imaging is the cornerstone of the pretranscatheter aortic valve replacement (TAVR) assessment. Multi‐detector computed tomography (MDCT) is considered the conventional imaging modality. However, there is still no definitive gold standard. Targeted cohort of inoperable high‐risk patients with underlying comorbidities, particularly renal impairment, makes apparent the need for MDCT alternative. We aimed to demonstrate the correlation extent between MDCT and three‐dimensional transesophageal echocardiography (3DTEE) aortic annular area measures and to answer the question: Is 3DTEE a good alternative to MDCT?

Incremental value of live/real time three‐dimensional transesophageal echocardiography in the assessment of ventricular septal rupture following acute myocardial infarction

Ventricular septal rupture is a serious complication following acute myocardial infarctions and is associated with a significant mortality rate. Classically, two‐dimensional transthoracic echocardiography has been used to diagnose this complication and visualize its location. Two‐dimensional transesophageal echocardiography has supplemented the transthoracic approach by providing more accurate assessment of the defect size and in guiding closure both percutaneously and intraoperatively. This modality, however, is limited to two‐dimensional views only, and a greater breadth of information is instead available through the use of three‐dimensional transesophageal echocardiography. We present a series of 11 patients in which live/real time three‐dimensional transesophageal echocardiography offered incremental benefits over two‐dimensional imaging alone.

Prominent pulmonary venous flow mimicking mitral regurgitation

The present case highlights a potential pitfall in assessing mitral regurgitation severity due to the presence of similar colored prominent pulmonary vein signals in the left atrium during color Doppler examination.

Two- and three-dimensional transthoracic echocardiographic assessment of superior vena cava, crista terminalis, and right atrial appendage using the right parasternal approach

The noninvasive assessment of superior vena cava (SVC), crista terminalis (CT), and the right atrial appendage (RAA) has clinical implications in determining the right atrium (RA) pressure in adult patients in whom the inferior vena cava cannot be imaged, in planning electrophysiological procedures and for evaluation of thrombi in RA/RAA. It is difficult to image these structures using standard two‐dimensional transthoracic echocardiography (2DTTE), but the right parasternal approach has shown promise in the very few studies published so far.

Usefulness of two- and three-dimensional transesophageal echocardiography in the assessment of proximal left coronary system compression by a paraprosthetic aortic valve abscess

Paraprosthetic aortic valve abscess represents a rare, but lethal complication of infective endocarditis. We report a case of proximal left coronary system compression by a paraprosthetic aortic valve abscess whose detection was augmented using live/real time three‐dimensional transesophageal echocardiography. Our case illustrates the usefulness of combined two‐ and three‐dimensional transesophageal echocardiography in detecting this finding.

Incremental benefit of three‐dimensional transesophageal echocardiography in the assessment of left main coronary artery stent protrusion

Ostial lesions represent a challenging clinical scenario and percutaneous intervention (PCI) of left main coronary artery ostial lesions has been associated with postintervention complications, including protrusion of deployed stents into a sinus of Valsalva or aortic root. We report a case of stent protrusion into the aortic root following aorto‐ostial left main coronary artery PCI, in which three‐dimensional transesophageal echocardiography (3DTEE) provided incremental benefit over standard two‐dimensional images. Specifically, 3DTEE confirmed the presence of stent protrusion by allowing clear visualization of the stent scaffold, in addition to characterizing the relationship between the stent and surrounding structures.

Incremental benefit of three-dimensional transesophageal echocardiography in the assessment of a primary pericardial hemangioma

Hemangiomas are rarely found in the heart and pericardial involvement is even more rare. We report a case of primary pericardial hemangioma, in which three‐dimensional transesophageal echocardiography (3DTEE) provided incremental benefit over standard two‐dimensional images. Our case also highlights the importance of systematic cropping of the 3D datasets in making a diagnosis of pericardial hemangioma with a greater degree of certainty. In addition, we also provide a literature review of the features of cardiac/pericardial hemangiomas in a tabular form.