Recent progress of ultrasound diagnostic imaging in cardiovascular disease: Development of real-time two-dimensional Doppler echocardiography

In acquired valvular disease, 2-D Doppler findings of valvular regurgitations in aortic, mitral, and tricuspid positions are highly correlated with angiographic or operative findings. In detecting paravalvular leakages in patients with a prosthetic valve, 2-D Doppler is sensitive and accurate. The combined use of 2-D Doppler and CW is effective in evaluating combined valvular lesions, i.e. stenosis associated with regurgitation. In 204 of 208 patients with congenital heart disease, intracardiac shunts, abnormal blood flow in the great arteries, blood flow of valvular stenosis and regurgitation are clearly imaged with 2-D Doppler. 2-D Doppler is very useful for determining the optimal timing of palliative shunt surgery and in evaluating its effectiveness. Blood flow through entries, re-entries or both in dissecting aortic aneurysms are clearly imaged when ultrasound beams are sufficiently transmitted toward involved areas. Intraoperative use of 2-D Doppler is helpful for surgery in patients with dissecting aortic aneurysm, congenital heart disease, and valvular disease. It has permitted the precise diagnosis and assessment of degree of surgery before cardiopulmonary bypass. Intraoperative 2-D Doppler has evaluated effects of surgery before the chest is closed. This technique has also been beneficial to valvular plasty. The new modality, 2-D Doppler, yields, noninvasively, new diagnostic information on intracardiac blood flow in wide areas of cardiovascular disease