4.4 The role of 3D TEE compared to 2D TEE
In a clinical setting, we used to suspect LVOT obstruction when we saw
the encroachment of the stent valve toward LVOT space by 2D LV long-axis
views. Also, we’ve frequently experienced that a stent valve may
severely encroach into the LVOT without significant subsequent elevation
of LVOT velocity. This apparent discrepancy may be explained by this
study; the dimension between the
stent struts and ventricular septum from 2D LV long-axis view was the
minimum at the valve stent distal edge, while 3D derived LVOT cross
sectional area was typically the maximum at the valve stent distal edge
(Figure 4). Our study suggests the need of the 3D TEE if LVOT
obstruction is suspected during or after the procedure by 2D LV
long-axis view.