椎名 由美

Yumi SHIINA

聖路加国際病院循環器内科

Cardiovascuar Center, St. Luke’s International Hospital

キーワード :

In this presentation, I will talk about the usefulness of 2D speckle tracking and 3D echo in adults with congenital heart disease. I will show the unique case of the single ventricle with septation procedure and will discuss the usefuleness and limitations.　
Good indications for 3D echo assessments in ACHD are the followings:
1）LV function
Left ventricular function assessment, both global and regional.
2）RV function
Measurements of right ventricular volume and function can be obtained in some patients, but this use is currently more experimental.
3）Aortic valve and AV valve
3DE is good at imaging thickened aortic valves and bicuspid aortic valve. AV valves in AVSD and the tricuspid valve in Ebstein’s anomaly etc are sometimes visible clearly by 3DE.
4）Structure heart disease
Guidance of transcatheter procedures is a common（and recommended）use for 3DE in adults, including atrial and ventricular septal defect closure, transcatheter aortic valve implantation, left atrial appendage closure, and mitral valve intervention（mitral clips or mitral valvuloplasty）.
5）Dyssynchrony assessment before CRT
Assessments of dyssynchrony remain challenging. CRT was technically feasible and associated with improvements in cardiac mechanical function and clinical status in patients with TGA/CCTGA, failing systemic RV, and intraventricular dyssynchrony.