the art of defining cardiac morphology

Co-Director & Division Chief
Congenital Heart Center
Helen DeVos Children's Hospital
100 Michigan NE
Grand Rapids, MI 49503


This website aims to develop an international portal for learning the complex and dynamic morphology of the congenitally
malformed heart through discussion and interaction. The main focus is on the clinical appliaction of advanced cardiac imaging in
the assessment of cardiac morphology and function.

Three-dimensional echocardiography: (3DE, also referred to as 4DE with the fourth dimension being time) is a unique method of
visualizing the true and dynamic morphology of the heart. The technique is not just a way of displaying moving images of the
heart in 3D rather 3DE incorporates a core of biometric data set frozen in time. This enables the cardiologist to bring the
frozen heart to life and to dissect it, time and time again enabling comparison between pre and postoperative anatomy and learn
from mistakes. It is also possible to share the data electronically between professionals. With the availability of cloud-based
data sharing sites like Dropbox or Google Drive etc.,it is now possible to receive and report on a large number of patients from
different countries and institutions.

MPR:The most important aspect of 3DE is the potential to slice the dynamic cardiac structures in infinite planes through
the three dimensions similar to a cardiac pathologist dissecting the heart to reveal underlying pathology. This method of analysing
the anatomy is termed Multiplanar Reformating or Multiplane Review (MPR). I improvised this technique by moving the planes of
dissection, in anatomically appropriate planes throughout the cardiac cycle to accurately define the underlying pathology from which
the 3D morphology is reconstructed. This technique is most useful in assessing complex congenital heart defects. It is also helpful to
understand the anatomy when resolution of the images are poor and a visually useful 3D image cannot be reconstructed. It marks a
transitional phase between 2D and 3D imaging within the restrictions of current image resolution.

Take some time to explore the website. Individual heart defects are discussed under heart defects. For further details of the techinques,
please also refer to the recent publication in Heart. Please feel free to contact me if you have any comments, questions or would like to
send any images for assessment and/or discussion.

Image of the Month

Perforated Mitral Valve due to Endocarditis

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