ABSTRACT
We evaluated tricuspid regurgitation (TR) by multiple echocardiographic techniques in 93 consecutive patients who underwent standard two-dimensional (2D) and live three-dimensional (3D) transthoracic echocardiography (TTE). TR vena contracta (VC) area was obtained by 3D TTE by systematic and sequential cropping of the acquired 3D TTE dataset. Assessment of VC area by 3D TTE was compared to 2D TTE measurements of the ratio of TR regurgitant jet area to right atrial area (RJA/RAA), RJA alone, VC width, and calculated VC area. VC area from 3D TTE closely correlated with RJA/RAA and RJA alone as determined from 2D TTE measurements. Live 3D TTE color Doppler measurements of VC area can be used for quantitative assessment of TR and offer incremental value for quantification of particularly severe regurgitant lesions.
Subject(s)
Echocardiography, Doppler, Color , Echocardiography, Three-Dimensional , Tricuspid Valve Insufficiency/diagnostic imaging , Adolescent , Adult , Aged , Aged, 80 and over , Alabama , Female , Humans , Image Processing, Computer-Assisted , Linear Models , Male , Middle Aged , Observer Variation , Pulmonary Wedge Pressure , Sensitivity and Specificity , Severity of Illness Index , Stroke Volume , Tricuspid Valve Insufficiency/epidemiology , Tricuspid Valve Insufficiency/physiopathology , Ventricular Function, RightSubject(s)
Computer Systems , Defibrillators, Implantable/adverse effects , Echocardiography/methods , Imaging, Three-Dimensional , Pacemaker, Artificial/adverse effects , Prosthesis-Related Infections/etiology , Staphylococcal Infections/etiology , Aged , Humans , Male , Prosthesis-Related Infections/diagnostic imaging , Prosthesis-Related Infections/pathology , Staphylococcal Infections/diagnostic imaging , Staphylococcal Infections/pathologyABSTRACT
We describe our experience in using live/real time three-dimensional transthoracic echocardiography (3D TTE) in the assessment of five adult patients with Ebstein's anomaly. The technique was found useful in assessing the distribution and extent of tethering of each of the three leaflets of the tricuspid valve (TV) to the underlying right ventricular walls and the ventricular septum. The characteristic bubble-like appearance resulting from bulging of the non-tethered areas of the TV leaflets was also well visualized in three dimensions and their size measured. Thus, an estimate of the nontethered or free segments of all three leaflets of the TV could be obtained using this technique. This has important implications when considering these patients for surgical repair of the TV. Visualization of all three leaflets of the TV and their extent of tethering by 3D TTE also made it easier to identify the boundaries of the functioning right ventricular chamber potentially providing a more reliable assessment of its volumes and ejection fraction. Cropping of color Doppler 3D TTE data sets provided en face viewing of the TV regurgitation vena contracta permitting accurate assessment of its shape and size. This has the potential to provide a more accurate quantitative estimation of TV regurgitation severity as compared to two-dimensional color Doppler. In conclusion, live/real time 3D TTE appears useful in supplementing two-dimensional echocardiography in more comprehensively assessing the morphologic features of Ebstein's anomaly.
