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Real-Time Multiplanar Reconstruction (MPR) Imaging Using 3D Transesophageal Echocardiography in Structural Heart Interventions

Published:November 13, 2022DOI:https://doi.org/10.1053/j.jvca.2022.11.011

      Abstract

      The complexity of structural heart interventions has led to a demand in sophisticated periprocedural imaging guidance. While traditional 2D transesophageal techniques are widely used, new-generation 3D ultrasound probes enable high temporal and spatial resolution. Multiplanar reconstruction of acquired 3D datasets has gained considerable momentum for precise imaging and to increase validity of measurements. Previously, this technique was used after acquisition of suitable 3D datasets. Recent advances in technology have enabled the use of live mode for multiplanar reconstruction across different ultrasound vendor platforms. The use of live multiplanar reconstruction can enhance the precision in real-time imaging, enable simultaneous visualization of structures of interest in multiple planes, reduce the need for probe manipulation and thereby contribute to the success of the procedures. In this narrative review, we describe the rationale and utility for 3D transesophageal live multiplanar reconstruction and outline its use for the structural heart interventions of mitral and tricuspid valve edge-to-edge repair, left atrial appendage occlusion, and the Lampoon procedure. 3D TEE with live-multiplanar reconstruction has the potential to advance guidance of these complex interventions.

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