LAUSR

BackgroundReal-time three dimensional transoesoph-ageal echocardiography (RT 3D-TEE) may better reflect left ventricle (LV) shape and function than cconventional 2D-TEE. The goal of this study was to evaluate the ad-vantages of 3D analysis in shape assessment and to quantify the LV volume by ejection fraction (EF) measurement, after LV surgi-cal remodelling.MethodsIn a prospective manner, twenty consecu-tive coronary surgery patients with LV an-teroapical aneurysm and functional mitral regurgitation were analyzed by 2D- and thereafter by 3D- TEE before and after surgery. The key intraoperative inclusion criteria was a LVEF < 30% confirmed by intraoperative 3D-TEE immediately before surgical remodeling.ResultsBefore surgery, the geometry of post infarc-tion aneurysm shows negative curvatures of the antero-basal and infero-apical seg-ment and the apex of LV is shifted clock-wise, towards the mitral valve. Surgery had significantly reduced the LV volumes and the LVEF had increased by 13.3% as recorded by 2D-TEE and by 18.3% as as-sessed by 3D-TEE quantification (p < 0.001 for both). Accordingly, the longitudinal plane had been shortened, the apex was now shifted anti-clockwise towards the aorta and the inferior region had taken a more important function of the LV. Signifi-cantly lower values were observed in the EF measurement with 3D- vs 2D-TEE before remodelling (22.3 vs. 29.7%, p = 0.048). ConclusionImprovement of LV function occurred due to the increased systolic contraction of the inferior region after remodelling in pa-tients with postinfarction aneurysm.