Abstract
Introduction. In modern cardiac surgery, when a valve due to complications is necessary to obtain accurate
diagnostic data, as this may vary from patient management. This is especially true of such a complex disease
as a dysfunction of mechanical prostheses, which requires the highest level of diagnostic, since such a diagnosis
is often threatened with re-operation for prosthesis replacement. There are examples of when the dysfunction
prostheses 2D echocardiography information was not enough, and it is to a large extent, been clarified
and specified the method of 3D. Thanks to the three-dimensional scanning was possible to determine
the size, extent and localization of fistulae, abscesses around the prosthesis,the size and the prevalence of
thrombotic masses on the prosthesis cuff, vegetation and pannus.
Material and methods. In 3D mode studied 7 patients with different types of complications associated with
mechanical prosthetic heart valves at mitral and aortic positions.
For diagnosis, in connection with suspected involvement in the pathological process of the ascending aorta
and the verification of the results two patients underwent MSCT-AG.
Results. Abscess of the aortic root with the formation of paraproteins fistula diagnosed by transthoracic and
transesophageal 2D mode, needed in the elaboration of the topographic localization, size and length. Threedimensional
transesophageal echocardiography allowed to fully answer these questions, and the verification
conducted by the MSCT-AG, confirmed the results obtained by three-dimensional reconstruction.
Three-dimensional reconstruction made it possible to clearly see small tumors on the perimeter of the prosthesis.
Especially important and accurate information provides three-dimensional echocardiography in
determining the topography of fistulas and detachment of the prosthesis. In two-dimensional mode with a
color mapping diagnosed parapromysly flow with source diameter of 6–7 mm, but precise localization of the
fistula was determined only by the method of three-dimensional echocardiography. The most challenging in
echocardiography is the diagnosis of pannus, which has no precise ultrasound criteria. The pannus is defined
primarily by circumstantial evidence, such as uneven sealing cuff of the prosthesis, change the shape, depth
and character of the residual prosthetic regurgitation, with clear parameters, characteristic design features of
each model of the prosthesis, increase transportnyh gradients, and sometimes, in the most severe cases, are
showing signs of jamming of the obturator elements of the prosthesis.
Conclusion. 3D echocardiography is a modern, high-tech method of beam diagnostics, which allows you to
quickly and accurately obtain all of the required information and does not require additional material costs.
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