Live/real time three-dimensional transthoracic echocardiographic assessment of tricuspid valve pathology: Incremental value over the two-dimensional technique

Koteswara R. Pothineni, Kurt Duncan, Pridhvi Yelamanchili, Navin C. Nanda, Vinod Patel, Po Hoey Fan, Manjula V. Burri, Anurag Singh, Sadik R. Panwar

Research output: Contribution to journalArticlepeer-review

46 Scopus citations

Abstract

Twenty-nine patients with different tricuspid valve (TV) pathologies were studied by both two-dimensional transthoracic (2DTTE) and live/real time three-dimensional transthoracic echocardiography (3DTTE). A major contribution of 3DTTE over 2DTTE was the en face visualization of all three leaflets of the TV in all patients. This allowed accurate assessment of TV orifice area in patients with TV stenosis and carcinoid disease. Loss of TV leaflet tissue, defects in TV leaflets and size of TV systolic non-coaptation could also be delineated and resulted in identifying the mechanism of tricuspid regurgitation (TR) in patients with Ebstein's anomaly and rheumatic heart disease. Prolapse of TV leaflets could also be well visualized and enabled us to develop a schema for systematic assessment of individual segment prolapse which could help in surgical planning. The exact sites of chordae rupture in patients with flail TV as well as right ventricular papillary muscle rupture could be well seen by 3DTTE. 3DTTE also permitted sectioning of various TV masses for more specific diagnosis of their nature. In addition, color Doppler 3DTTE provided an estimate of quantitative evaluation of TR severity, since the exact shape and size of the vena contracta could be accurately assessed. In conclusion, our preliminary experience with 3DTTE has demonstrated substantial incremental value over 2DTTE in the assessment of various TV pathologies.

Original languageEnglish
Pages (from-to)541-552
Number of pages12
JournalEchocardiography
Volume24
Issue number5
DOIs
StatePublished - May 2007
Externally publishedYes

Keywords

  • Live/real time three-dimensional transthoracic echocardiography
  • Right ventricular papillary muscle rupture
  • Tricuspid valve prosthesis
  • Tricuspid valve regurgitation
  • Tricuspid valve stenosis
  • Two-dimensional transthoracic echocardiography

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