Utility of Three-Dimensional Transesophageal Echocardiography in the Diagnosis of Valvular Perforations

Three-dimensional (3D) transesophageal echocardiographic (TEE) imaging is a relatively new imaging modality that is increasingly being used to characterize a variety of cardiac pathologic features. In the present study, we reviewed the 2-dimensional (2D) and 3D TEE images from our echocardiographic database to identify patients with valve perforations. A review of the 2D TEE images resulted in the identification of 11 valvular perforations (6 aortic valves, 4 mitral valves, and 1 tricuspid valve). A review of the 3D TEE images allowed for the identification of 15 valve perforations (7 aortic valves, 7 mitral valves, and 1 tricuspid valve), including 4 perforations that could not be diagnosed using 2D imaging alone. In conclusion, 3D TEE imaging provided added benefit to traditional 2D TEE imaging because of its ability to provide en face visualization of the cardiac valves, allowing improved identification and precise anatomic localization of the perforation.