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3D Volume Echocardiography:

Answering the Challenges of the Right

HeartMichael Pfeiffer, MD

Assistant Professor of Medicine Cardiology Penn State Hershey Heart and Vascular Institute

Hershey, Pa.

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Evolution of 3D Volume Imaging

Faster computers boost volume

Real-time, single-beat acquisition

Window into the right heart

Work toward quantitative measurements

More effective vs. CT, MR

Quantification of theright heart for the first time

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Evolution of 3D Volume Imaging

More common in practices today

New availability of quantification

MR no longer needed as often

Quantified assessment of size andfunction in an easy acquisition

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Evolution of 3D Volume Imaging

Ease of use

Semi-automated assessment

Information in physicians’ hands

Prevalence of echo & affordable price

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The Challenges of the Right Heart

Adult congenital patientsRight heart: An indicator of severity and

prognosisAbnormal volume loading or pressure conditionsMorphology changes differently than left heartCrescent shape of right heart distortionMoves in rarely predictable ways

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How 3D HelpsVolume imaging allows quantification3D echo will increase in value with more

populations, namely in quantifying abnormalright hearts

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Routine ImagingPatients with abnormal conditions of right heart

Abnormal morphology and shape – volume imaging helps to define these conditions

No measurements yet to classify mild, moderate or severe pathology, dilation in right heart

Volume image opens opportunity to quantify cut points

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Right Heart in Real TimeQuantification Post-processing

Identify points system picks views,endocardium is traced

Provides full volume tracing of right heart, quantified numbers of size, estimates of systolic function and volumes

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Inside the TechnologyMore automation

Measurements – 3D volume, define where we slice through the heart

Better assess where we are looking in right heart via defined landmarks

Better refine 2D measurements – reproducible, predictable, confidence in measurement

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Improved Patient CareMore concrete information for diagnosis and

management

Avoids stress of MRI

3D allows more routine follow ups for patients

Real-time color flow analysis New views,size, flow, structural issues

3D PISA Boost accuracy

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Full Automation: Single Beat Analysis

Right heart presents challenges

Real-time 3D echo allows us to visualize

Improves visualization vs. MRI

MRI still requires user input vs. full automation

Advancements are coming:congenital right heart conditions, right heart under stress, pulmonary hypertension

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Right Heart ImagingNot as advanced as left heart imaging

Limited ability to image right heart

Single beat volume analysis offers potentialto different normal and abnormal

Better patient management

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Cost ComparisonsGold standard = MRI; however echo requires

less staff and affordable imaging equipment

Inpatient: No longer requires a dedicated room

Outpatient: Tested anywhere with echo

Easier access for physicians and patients

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Payment and Pre-Authorization

Volume imaging reduces need for:Pre-authorizationScreening Lab work

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Evolving TechnologyComputer strength increasing capabilities

Fully-automated process possible

Increase in affordability and accessibility

Better picture quality with lower file size

Implementation broadening overseas

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Value of 3D Volume ImagingRight heart value sub-specialized in patients

with right heart disease

Left heart used more regularly

More accurate quantifications

Sponsored by

3D Volume Echocardiography:

Answering the Challenges of the Right

HeartMichael Pfeiffer, MD

Assistant Professor of Medicine Cardiology Penn State Hershey Heart and Vascular Institute

Hershey, Pa.