Feasibility of Intraoperative 3-Dimensional Speckle-Tracking Echocardiography in Patients Undergoing Surgical Aortic Valve Replacement: A Prospective Observational Pilot Study

J Cardiothorac Vasc Anesth. 2025 Jan;39(1):61-68. doi: 10.1053/j.jvca.2024.09.146. Epub 2024 Oct 9.

Abstract

Objectives: To assess the feasibility of intraoperative 3-dimensional speckle-tracking-based myocardial deformation analysis for evaluation of twist, torsion, and strain using speckle tracking, and to investigate the immediate changes in these parameters after aortic valve replacement.

Design: Prospective observational study SETTING: Single-center study at a tertiary academic cardiac center PARTICIPANTS: Forty-nine patients undergoing minimally invasive surgical aortic valve replacement INTERVENTIONS: Acquisition of full-volume images of the left ventricle after induction of anesthesia and at the end of surgery using transesophageal echocardiography (TEE), and analysis of the datasets using 3D speckle-tracking-based myocardial deformation analysis (Tomtec Arena).

Measurements and main results: Of the 49 complete volume datasets, 30 (61%) had quality sufficient for speckle tracking. No significant differences were observed between the examinations in terms of ejection fraction (EF) (p = 0.177), global longitudinal strain (GLS) (p = 0.276), circumferential strain (CS) (p = 0.238), twist (p = 0.970), or torsion (p = 0.417).

Conclusions: 3D speckle-tracking-based myocardial deformation analysis from intraoperative TEE datasets is feasible in >60% of patients with aortic valve stenosis. There were no statistically significant differences in GLS, CS, twist, or torsion between the intraoperative examinations.

Keywords: aortic valve stenosis; cardiac surgery; speckle-tracking echocardiography; strain; torsion; twist.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Aortic Valve Stenosis / diagnostic imaging
  • Aortic Valve Stenosis / surgery
  • Aortic Valve* / diagnostic imaging
  • Aortic Valve* / surgery
  • Echocardiography, Three-Dimensional* / methods
  • Echocardiography, Transesophageal* / methods
  • Feasibility Studies*
  • Female
  • Heart Valve Prosthesis Implantation* / methods
  • Humans
  • Male
  • Middle Aged
  • Monitoring, Intraoperative* / methods
  • Pilot Projects
  • Prospective Studies