Key result
Live 3D-transthoracic echocardiography correctly identified a larger orifice area (2.29 cm2) and no significant obstruction in a patient with a discrete subaortic membrane, avoiding misdiagnosis by 2D Doppler.
Why the study?
Does 3D TTE improve the diagnostic accuracy of LVOT obstruction compared to 2D Doppler echocardiography in a patient with a discrete subaortic membrane?
Case Report (n=1)
Does 3D TTE improve the diagnostic accuracy of LVOT obstruction compared to 2D Doppler echocardiography in a patient with a discrete subaortic membrane?
3D transthoracic echocardiography can prevent erroneous diagnosis of significant LVOT obstruction caused by 2D Doppler in patients with discrete subaortic membrane.
May prevent erroneous LVOT obstruction diagnosis in discrete subaortic membrane; hypothesis-generating and should not change practice yet.
We report an adult with a discrete subaortic membrane in whom two-dimensional transthoracic Doppler echocardiography demonstrated peak and mean gradients of 64 and 33 mmHg, respectively in the left ventricular outflow tract (LVOT) and a calculated orifice area by continuity equation of 1.14 cm(2) consistent with significant obstruction. However, by direct en face visualization of the LVOT at the level of the membrane by live/real time three-dimensional transthoracic echocardiography (3D TTE), a larger orifice measuring 2.29 cm(2) was seen and was indicative of no significant obstruction. This finding was confirmed at cardiac catheterization, which showed insignificant obstruction.
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Bandarupalli et al. (2008) conducted a case report in Discrete subaortic membrane (n=1). 3D-Transthoracic Echocardiography (3D TTE) vs. Two-dimensional transthoracic Doppler echocardiography was evaluated on Orifice area and obstruction severity. Live 3D-transthoracic echocardiography correctly identified a larger orifice area (2.29 cm2) and no significant obstruction in a patient with a discrete subaortic membrane, avoiding misdiagnosis by 2D Doppler.
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