Dr. Michael Pfeiffer, a cardiologist and assistant professor of medicine at Penn State Hershey Heart and Vascular Institute in Hershey, Pa. discusses the advantages of 3D volume echocardiography in the right heart.

1. Sponsored by
3D Volume
Echocardiography:
Answering the Challenges of
the Right Heart
Michael Pfeiffer, MD
Assistant Professor of Medicine Cardiology
Penn State Hershey Heart and Vascular Institute
Hershey, Pa.

2. Sponsored by
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 the
right heart for the first time

3. Sponsored by
Evolution of 3D Volume Imaging
 More common in practices today
 New availability of quantification
 MR no longer needed as often
 Quantified assessment of size and
function in an easy acquisition

4. Sponsored by
Evolution of 3D Volume Imaging
 Ease of use
 Semi-automated assessment
 Information in physicians’ hands
 Prevalence of echo & affordable price

5. Sponsored by
The Challenges of the Right Heart
 Adult congenital patients
 Right heart: An indicator of severity and prognosis
 Abnormal volume loading or pressure conditions
 Morphology changes differently than left heart
 Crescent shape of right heart  distortion
 Moves in rarely predictable ways

6. Sponsored by
How 3D Helps
 Volume imaging allows quantification
 3D echo will increase in value with more populations,
namely in quantifying abnormal
right hearts

7. Sponsored by
Routine Imaging
 Patients 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

8. Sponsored by
Right Heart in Real Time
 Quantification  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

9. Sponsored by
Inside the Technology
 More 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

10. Sponsored by
Improved Patient Care
 More 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

11. Sponsored by
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

12. Sponsored by
Right Heart Imaging
 Not as advanced as left heart imaging
 Limited ability to image right heart
 Single beat volume analysis offers potential
to different normal and abnormal
 Better patient management

13. Sponsored by
Cost Comparisons
 Gold 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

14. Sponsored by
Payment and Pre-Authorization
 Volume imaging reduces need for:
 Pre-authorization
 Screening
 Lab work

15. Sponsored by
Evolving Technology
 Computer strength increasing capabilities
 Fully-automated process possible
 Increase in affordability and accessibility
 Better picture quality with lower file size
 Implementation broadening
overseas

16. Sponsored by
Value of 3D Volume Imaging
 Right heart value sub-specialized in patients
with right heart disease
 Left heart used more regularly
 More accurate quantifications

17. Sponsored by
3D Volume
Echocardiography:
Answering the Challenges of
the Right Heart
Michael Pfeiffer, MD
Assistant Professor of Medicine Cardiology
Penn State Hershey Heart and Vascular Institute
Hershey, Pa.