Author + information
- Kevin M. Cummisford, MD⁎ (, )
- Warren Manning, MD,
- Swaminathan Karthik, MD and
- Feroze U. Mahmood, MD
- ↵⁎Intermountain Medical Center, Department of Anesthesiology, 5121 Cottonwood Street, Murray, Utah 84157
Real-time 3-dimensional echocardiography allows for better visualization and understanding of morphology-to-function correlation among 3-dimensional cardiac phenomena than was possible with 2-dimensional echocardiography in the past (Online Videos 1 and 2) (1) (Fig. 1). One such phenomenon is the systolic anterior motion of the anterior mitral valve leaflet, which is seen in 31% to 61% of patients with hypertrophic cardiomyopathy and its consequence, a dynamic left ventricular outflow tract (LVOT) obstruction (2). Presumably, real-time 3-dimensional echocardiography can better show the anatomical findings including the large, anteriorly placed mitral valve leaflets, short chordae tendinae, narrow LVOT, an anterior position of the papillary muscles and more importantly, allow for evaluating LVOT obstruction better than the current 2-dimensional echocardiography. We show that real-time 3-dimensional transesophageal echocardiography can very clearly demonstrate obstruction of the LVOT caused by the anterior mitral valve leaflet in hypertrophic cardiomyopathy as well as show the changes in anterior mitral valve leaflet–LVOT geometry associated with changes in afterload in these patients.
For supplementary videos and their legends, please see the online version of this article.
Drs. Manning, Karthik, and Mahmood are from the Beth Israel Deaconess Medical Center, Boston, Massachusetts.
- American College of Cardiology Foundation