Heterogeneity in the Structure of the Left Ventricular Outflow Tract: A 3-Dimensional Transesophageal Echocardiographic Study

BACKGROUND: The left ventricular outflow tract (LVOT) is a composite of adjoining structures; therefore, a circular or elliptical shape at one point may not represent its entire structure. The purpose of this study was to evaluate the presence of heterogeneity in the LVOT. METHODS: Patients with normal valvular and ventricular function undergoing elective coronary revascularization surgery were included in the study. Intraoperative R-wave gated 3-dimensional (3D) transesophageal echocardiographic imaging of the LVOT was performed at end-systole, with the midesophageal long axis as the reference view. Acquired data were analyzed with the Philips Q-Lab software with multiplanar reformatting in the sagittal (minor axis), transverse (major axis), and coronal (cross-sectional area by planimetry) views of the LVOT. These measurements were made on the left ventricular side or proximal LVOT, aortic side, or distal LVOT and mid-LVOT. RESULTS: Fifty patients were included in the study. The LVOT minor (sagittal) axis dimension did not differ across the mid-LVOT, proximal LVOT, and distal LVOT (P = .11). The major axis diameter of LVOT differed among the 3 regions of the LVOT (P

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