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.