Table 3

Potential Advantages of 3D Echocardiography Compared With 2D Echocardiography for LAA Evaluation

3D TEE can be helpful in differentiating a thrombus from other findings, such as pectinate muscles within the LAA (35).
3D echocardiography is superior to 2D echocardiography for assessment of thrombus mobility and differentiation between the thrombus and the myocardium (36).
3D echocardiography is superior to 2D echocardiography for delineation of the changes in thrombi structure (e.g., calcification, degeneration, or lysis) (36).
3D echocardiography measurements of maximum thrombus diameter showed better interobserver agreement than 2D echocardiography (36).
LAA volume calculation and volume-derived ejection fraction can be obtained by 3D echocardiography only (36,42).
3D TEE renders additional information compared with 2D TEE regarding type and site of intracardiac masses, surface features, and spatial relationship to surrounding structures (37).
3D echocardiography (transthoracic echocardiography [TTE]/TEE) is superior to 2D echocardiography (TTE/TEE) in the adequate visualization of the entire LAA (38).
The LAA orifice area is measured more precisely by 3D TEE using enface views; 3D measurements correlated well with MDCT values, whereas 2D TEE underestimates the LAA orifice area (18,39).
2D TTE/TEE probably underestimates the dimensions of intracardiac masses, compared with 3D TTE/TEE, regardless of the size, location, and cause of the mass (37,40).
An excellent correlation on volume measurement between 3D TEE and surgically removed masses has been demonstrated (41).
3D TEE is superior to 2D TEE in visualizing the LAA orifice in relation to surrounding structures (e.g., mitral valve, left upper pulmonary vein) (43).

LAA = left atrial appendage; MDCT = multidetector computed tomography; TEE = transesophageal echocardiography; TTE = transthoracic echocardiography; 2D = 2-dimensional; 3D = 3-dimensional.