Transthoracic and Transesophageal Echocardiography
Transthoracic echocardiography (TTE) examinations were performed with a commercially available machine (IE33 or EpiQ CVx, Philips Medical System, USA) ultrasound system equipped with a 2- to 3.5-MHz transducer in the left lateral decubitus position. On top of conventional echo measurements, AR severity was evaluated comprehensively and graded in 3 grades (mild, moderate, severe) in accordance with the guidelines of the American Society of Echocardiography (12) (13). The study subjects of this study were those with moderate or severe AR. In addition, after a consent form of TEE was obtained from every patient, TEE was performed with a transducer (X7-2t or X8-2t) for further evaluation of AR within 3 months after the TTE examination. 2D and 3D TEE grayscale and color images were acquired at the level of the aortic valve and root in all the patients. All images were stored digitally and transferred onto a dedicated image server for subsequent review.