Abstract
A new surgical treatment for end-stage cardiomyopathy consists of resection of a posterolateral myocardial wall-segment We hypothesized that intraoperative three dimensional echo (3DE) is useful for assessment of left ventricular geometry, volumes and success of surgery. Methods: We studied 8 pts (5 males), mean age 52 ± 9.2 yrs with dilated cardiomopathy and mitral regurgitation undergoing LV remodeling (LVR). We performed pre and post LVR two dimensional echo (2DE) and 3 DE (TomTec, 10°, multiplane probe) for endsystolic (ESV), enddiastolic volume (EDV) and ejection fraction (EF). For LV quantification the single plane (Simpson) method was used by 2DE and 8 parallel LV short axis planes with 5 mm thickness were traced by 3DE. Multiple intracavitary 3D views were displayed intraoperatively. Results: 3D echo was accomplished in all patients pre- and post LVR. 3DE volumes correlated (r) with 2DE. LV function improved significantly post LVR by 2DE and 3DE: (Δ = mean amount of change pre to post LVR,*p<0.01) Pre LVR Post LVR Δ 2DE 3DE r 2DE 3DE r 2DE 3DE ESV (ml) 161±42 138±47 0.9 52±15 58±14 0.5 -109*-80*EDV (ml) 198±48 176±52 0.9 88±18 82±20 0.3 -110*-94*EF (%) 17±6 19±4.6 0.7 41±7 29±3 n +24*+10*Conclusions: 1. 3DE is feasible for the assessment of LV volumes during LVR. 2. While an excellent agreement between 3DE and 2DE was seen preoperatively, 3DE is superior to 2DE postoperatively to assess the geometric distortion of the LV 3. 2DE and 3DE show comparable significantly improved LV function post remodeling.