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Navin Nanda

Publications and source records attributed to Navin Nanda.

5 recordsLinked to original sources

Real time three-dimensional echocardiography in assessing ventricular septal defects: an echocardiographic-surgical correlative study.

BACKGROUND: Two-dimensional echocardiography (2DE) enhanced by combining with color Doppler technology has significant limitations in providing precise quantitative information, geometric assumptions to calculate chamber volume, mass, and ejection fraction. Reconstructed three-dimensional echocardiographic (3DE) systems (from multiple cross-sectional echocardiographic scans) are still cumbersome and time-consuming. Real time 3DE (RT-3DE) with shorter imaging time than with 3D reconstruction techniques can obtain qualitative and quantitative information on heart disorders. Our purpose was to investigate the feasibility and potential value of RT-3DE as a means of accurately and quantitatively estimating the size of VSD to correlate with the surgical findings. MATERIALS AND METHODS: 38 patients with VSD were examined with RT-3DE. 3D image database was postprocessed using TomTec echo 3D workstation. The results were compared with the results measured by 2 DE and surgical findings. RT-3DE produced novel views of VSD and improved quantification of the size of the defect. The sizes obtained from 3DE have equivalent correlation with surgical findings as diameter measured by 2DE (r = 0.89 vs r = 0.90). Good agreement between blinded observers was achieved by little interobserver variability. CONCLUSION: RT-3DE offers intraoperative visualization of VSD to generate a "virtual sense of depth" without extending examining time. From an LV en face projection, the positions, sizes, and shapes of VSDs can be accurately determined to permit quantitative recording of VSD dynamics. It is a potentially valuable clinical tool to provide precise imaging for surgical and catheter-based closure of difficult perimembranous and singular or multiple muscular VSD.

Cardiac Surgical Procedures↗

Transesophageal Three-Dimensional Echocardiographic Assessment of Normal and Stenosed Coronary Arteries.

We describe our preliminary experience in assessing normal and stenosed coronary arteries using transesophageal three-dimensional echocardiography (3-D echo) in 27 adult patients. Multiplane transesophageal two-dimensional images of the coronary arteries (20 left, 3 right, 3 both left and right, and 1 posterior descending) were first acquired in the TomTec computer in 3 degrees sequential increments, from 0 degrees to 180 degrees, and then 3-D reconstruction was performed. The entire left main (LMC, measuring 0.5 to 1.7 cm, mean 1.0 cm) as well as variable lengths of proximal or both proximal and middle segments of the left anterior descending (LAD, measuring 0.2 to 2.5 cm, mean 0.8 cm) and circumflex (LCX, measuring 0.2 to 2.8 cm, mean 0.9 cm) coronary arteries together with some of their branches could be visualized in 3-D in 22 of 23 patients. In the remaining patient, the LMC was absent, and both LAD and LCX could be visualized in 3-D as having separate but adjacent origins from the left sinus of Valsalva (proven by angiography). In two patients, long segments of interventricular and great cardiac veins were also visualized accompanying the LAD and LCX, respectively. The right coronary artery (RCA, measuring 0.7 to 3.0 cm, mean 1.9 cm) was also successfully delineated in 3-D in all six patients in whom an attempt was made to visualize it during echo examination. Using the transgastric approach, a long (1.8 cm) segment of the posterior descending branch (PDA) of RCA was imaged in one patient. In addition, nine significantly stenotic lesions (>50% lumen diameter) were identified by 3-D in eight patients involving LMC (1), proximal LAD (1), mid LAD (1), proximal LCX (2), proximal RCA (3), and mid PDA (1). Eight of these 9 lesions were confirmed by coronary angiography. The remaining lesion (mid PDA) could not be confirmed since the patient did not undergo angiography. Our preliminary study demonstrates the usefulness of transesophageal 3-D echo not only in delineating normal coronary arteries but also diagnosing significant atherosclerotic stenosis in these vessels. (ECHOCARDIOGRAPHY, Volume 13, September 1996)

Journal Article↗