日本小児循環器学会雑誌 Pediatric Cardiology and Cardiac Surgery

Recently, revolutionary advancements regarding the ultrasonic apparatus, three-dimensional (3D) echo probe, and PC analysis workstations have been achieved, and these have drastically improved the quality of 3D imaging. Additionally, 3D echocardiography has become one of the most useful diagnostic and therapeutic tools for congenital heart disease. One of the most effective applications is to provide critical information of complicated intracardiac 3D structures of the heart for planning cardiac surgery. This includes the creation of an intracardiac route via the ventricular septal defect in patients with a double outlet right ventricle, valvuloplasty for complicated atrioventricular valve regurgitation, or the repair of intracardiac stenotic lesions (e.g., pulmonary venous obstruction). The digitally acquired 3D volume data is reconstructed by “cropping” and then complex intracardiac structures can be observed from the surgeon’s standing point (i.e., surgeon’s viewpoint). Therefore, this technology can serve as the basis of profound communication between cardiologists and cardiac surgeons. In this chapter, I would like to address how to use 3D echocardiography as a guide for surgical repair in actual clinical practice and explain the process in detail for the pediatric cardiology trainees to understand with ease.