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Surgery for Ruptured Sinus of Valsalva Aneurysm into Right Ventricular Outflow Tract: Role of Intraoperative 2D and Real Time 3D Transesophageal Echocardiography

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Address for correspondence and reprint requests: Dr Shrinivas Gadhinglajkar, M.D., Additional Professor, Department of Anesthesia, Sree Chitra Tirunal Institute For Medical Sciences and Technology, Trivandrum, Kerala, Pin Code: 695011, India. Fax: (91) 0471-2446433; E-mail: shri@sctimst.ac.in

Abstract

A major limitation of the 2D echocardiography during surgery for a complex cardiac lesion is its inability to provide an accurate spatial orientation of the structure. The real time 3D transesophageal echocardiography (RT-3D-TEE) technology available in Philips IE 33 ultrasound machine is relatively new to an operation suite. We evaluated its intraoperative utility in a patient, who was operated for repair of a ruptured sinus of Valsalva aneurysm (RSOVA) and closure of a supracristal ventricular septal defect. The VSD and RSOVA were visualized through different virtual windows in a more promising way on intraoperative RT-3D-TEE than on the 2D echocardiography. The acquired images could be virtually cropped and displayed in anatomical views to the operating surgeon for a clear orientation to the anatomy of the lesion. RT-3D-TEE is a potential intraoperative monitoring tool in surgeries for complex cardiac lesions. (Echocardiography 2010;27:E65-E69)

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