Letters To The Editor
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World J Cardiol. Jul 26, 2014; 6(7): 689-691
Published online Jul 26, 2014. doi: 10.4330/wjc.v6.i7.689
3D-echo in preoperative assessment of aortic cusps effective height
Jan Nijs, Sandro Gelsomino, Bastian BLJH Kietselaer, Orlando Parise, Fabiana Lucà, Jos G Maessen, Mark La Meir
Jan Nijs, Bastian BLJH Kietselaer, Orlando Parise, Mark La Meir, Cardiothoracic Surgery, University Hospital, 1020 Brussels, Belgium
Sandro Gelsomino, Fabiana Lucà, Jos G Maessen, Cardiothoracic Department, Maastricht University Hospital, 6229 HX Maastricht, The Netherlands
Author contributions: Nijs J and Gelsomino S conceived and drafted the article; Kietslaer BBLJH, Parise O and Lucà F contributed to the imaging and revised the manuscript for important intellectual contents; Maessen JG and La Meir M approved the final version of the manuscript to be published.
Correspondence to: Sandro Gelsomino, MD, PhD, Cardiothoracic Department, Maastricht University Hospital, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands. sandro.gelsomino@libero.it
Telephone: +31-43-38881066
Received: December 31, 2013
Revised: April 17, 2014
Accepted: May 16, 2014
Published online: July 26, 2014
Processing time: 232 Days and 15.1 Hours
Abstract

Effective height, which represents the height difference between the central free margins and the aortic insertion lines can be easily determined by 2-D echocardiography and allows for identification of prolapse in the native cusps and assessment of prolapse correction after valve repair. Nonetheless, it allows to see only two of three aortic valve (AV) coaptation planes and this may lead to misunderstanding of the underlying pathophysiological mechanism for aortic regurgitation and hence in unsuccessful repair. In contrast, 3D transoesophageal echocardiography and multiple plane reconstruction lets visualize all the three coaptation planes between the AV cusps and it represents an invaluable tool in the assessment of aortic valve geometry. It is highly recommendable before AV repair to accurately study the complex three dimensional cusps anatomy and their geometric interrelation with aortic root.

Keywords: Aortic valve; Aortic repair; Aortic prolapse; Echocardiography

Core tip: 3D transesophageal echocardiography and multiple plane reconstruction lets visualize all the three coaptation planes between the aortic valve (AV) cusps and overcomes the limits of 2-D echocardiography which allows to see only two of three AV coaptation planes and this may lead to misunderstanding of the underlying pathophysiological mechanism for aortic regurgitation and hence in unsuccessful repair. It is highly recommendable before AV repair to accurately study the complex three dimensional cusps anatomy and their geometric interrelation with aortic root.