3D echo guidance seeing increasing use in congenital heart surgery

3D echo helps planning and in the operating room

The technology’s impact begins before surgery. Surgeons increasingly rely on 3D echo images to map out complex repairs and anticipate potential complications. In the operating room, the introduction of a pediatric 3D transesophageal probe has expanded possibilities further.

The instant feedback, she said, fosters stronger teamwork between echocardiographers and surgeons, who can now view heart structures from the same anatomical perspective. Unlike 2D imaging, which can appear inverted, 3D echo allows echocardiographers to rotate the heart into the “surgeon’s view,” ensuring consistent communication in the operating room and allowing surgeons to see the anatomy the same way as if they had opened the tissue to directly view it.

Reducing pediatric radiation dose in the cath lab

Beyond surgery, 3D echo is also moving into the catheterization lab, where it is helping to reduce radiation exposure. Traditionally, catheter-based interventions in children rely heavily on fluoroscopy, which carries risks of radiation and contrast use.

They usually use fluoroscopy, which is a lot of radiation contrast use, which is a lot of radiation. So

"With 3D echo we can see the catheters, we can see the device, and we can help our interventionalists get to where they need to go without stepping on fluoroscopy, which adds X-ray radiation. With the development of 3D echo, we can also now do valvuloplasties on really small babies. With a new pediatric 3D TEE probe, we can now do these procedural images all the way down to 5 kilos. So we can balloon the valve and open it for our patients without them going to surgery," Jone said.

Building congenital echo programs and collaboration

Jone has been instrumental in advancing the field, first at the University of Colorado and now at Lurie Children’s Hospital Heart Center, where she has trained teams of imagers and sonographers to acquire and process 3D data for use in surgical daily practice.

“When we're communicating with our surgeons, they actually are really trying to understand what we're saying in addition to the pictures, to augment their understanding of the anatomy. I think that's very helpful. That's the collaboration and the teamwork that we have built with our imagers and our surgeons, and our imagers and our interventionalists," Jone said.

International collaboration is also pushing the field forward. Jone helped establish a recurring 3D echo conference that alternates between U.S. and Canadian centers, including the Stollery Children’s Hospital in Edmonton and Calgary’s Alberta Children’s Hospital.

These meetings focus not only on surgical and interventional applications but also on functional imaging, such as assessing how well the heart contracts.

Looking ahead, Jone believes the future of 3D echo lies in continued refinement of imaging tools, stronger training programs and deeper integration of imagers into surgical and interventional teams.

"At the end of the day, we're taking care of the same patient, so it is critically important to have that teamwork in the operating room to communicate our findings to our surgeons and to be frank about it," Jone explained.

She said it is important that everyone on the team is speaking the same language. That often means communication and team effort, with dynamic collaboration between imagers and surgeons.