Juraj Podracký
The author reveals possibilities of classical transesophageal echocardiography (TEE) and three-dimensional real time transesophageal echocardiography (3T3D-TEE) in diagnosis, assessment of severity and management of aortic stenosis (AoS) and deals with the benefit of multimodal imaging of the aortal valve and aorta in this clinical unit. We can generally state that TEE provides higher resolution and better quality of imaging in most patients with aortic stenosis, and that RT3D-TEE that has recently been the integral part of transesophageal examination, enables more accurate evaluation of morphological conditions mostly in patients with inborn disorder of aortic valve (anomalies of number and shape of cusps, supra and infravalvular structures) and discrepancy in standard echocardiographic assessment of aortic stenosis severity. Dobutamin stress transesophageal echocardiography provides the most accurate evaluation of clinical severity of aortic stenosis in patients with left ventricular dysfunction. RT3D-TEE is the most suitable method of monitoring of the procedure of transcatheter aortic valve implantation (TAVI) and multimodality imaging (2D and 3D TEE, multidetector computer tomography – CT, MRI) has the main role in preprocedure assessment and selection of patients for TAVI and for cardiosurgical operations (plastic surgery and remodelation of the aortic valve). Multimodality imaging provides valuable information on anatomy of the aortic valve and severity of aortic stenosis.