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We applied biventricular pacing to a patient with severe ischemic dilated cardiomyopathy (left ventricular [LV] ejection fraction 19%, LV end-diastolic volume 360 mL, and complete left bundle branch block). An epicardial LV lead was surgically implanted concomitant with on-pump beating coronary artery bypass grafting and Dor's endoventricular circular patch plasty. Biventricular pacing immediately achieved the resynchronization of the LV contraction, and improved cardiac function as well as reducing mitral regurgitation. Biventricular pacing combined with cardiac surgery for patients with cardiomyopathy and complete left bundle branch block may produce beneficial effects on LV function.

Inflammatory abdominal aortic aneurysms (IAAAs) represent 3% to 10% of all AAAs. However, inferior vena cava occlusion secondary to an IAAA is rarely reported. We report a case of inferior vena cava occlusion secondary to an IAAA presenting deep venous thrombosis. As it is crucial to avoid pulmonary embolism and excessive blood loss during an operation, we pre-operatively implanted a venous filter and minimized intra-operative dissection that allowed successful operative repair.

Transthoracic and transeshophageal real-time three-dimensional (3D) echocardiographic technique provides a unique ‘en-face‘ view of the mitral leaflets and annulus by an easy acquisition of pyramidal images of whole beating heart. Conventional two-dimensional (2D) echocardiography has been greatly contributing in the clinical diagnosis of mitral valve diseases and it is certainly the standard in clinical echocardiography for the evaluation of mitral valve. Nevertheless, 2D has a disadvantage in the assessment of 3D morphology of the mitral valve complex, which is consisted of the saddle shaped annulus, four leaflets, chordae and papillary muscles. Although welltrained echocardiographers can reconstruct the 3D shape and position of the structures by multi-scanned 2D images (mental reconstruction), the newly-developed 3D echocardiographic system allows us to visually understand the configuration of the complex mitral valve morphology. Furthermore, the reconstructed 3D images can be quantitatively measured and analyzed in 3D spaces, which have never been done in 2D images. Three-dimensional evaluation of the mitral valve provides us important additional information in the clinical diagnosis of mitral valve diseases. In this session, I would like to introduce some clinical data regarding the assessment of ischemic mitral regurgitation by 3D echocardiography.