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Transthoracic three-dimensional echocardiography for the assessment of straddling tricuspid or mitral valves

Published online by Cambridge University Press:  19 August 2008

Michael Vogel ,
Siew Yen Ho ,
Christopher Lincoln  and
Robert H. Anderson
Michael Vogel*
Affiliation:
GUCH Department, Middlesex Hospital, London;
Siew Yen Ho
Affiliation:
National Heart and Lung Institute Imperial College School of Medicine, London
Christopher Lincoln
Affiliation:
Royal Brompton Hospital, London;
Robert H. Anderson
Affiliation:
The Cardiac UnitInstitute of Child Health, London, UK
*
Dr Michael Vogel, GUCH Department, Middlesex Hospital, Mortimer Street, London WIN 8AA, UK. Tel: +44 207 3809468, Fax: +44 207 380 9469, E-mail: drmichaelvogel@S-doctors.net uk
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Abstract

Background

The advent of 3D echocardiography has provided a technique which, potentially, could afford significant additional information over conventional cross-sectional echocardiography in the assessment of patients with straddling atrioventricular valves prior to surgical correction.

Methods

Eight patients, aged from 1 month to 9˙2 years, were examined with 3D echocardiography. All but three had discordant ventriculoarterial connections or double outlet right ventricle. Data suitable for reconstruction was acquired with transthoracic scanning. Right and left ventricular volumes were calculated in the 3D dataset.

Results

3D echocardiography proved capable of defining the exact degree of straddling by imaging theproportion of tension apparatus attached to either side of the ventricular septum. It was able also to display the atrioventricular junction “en face”, thus permitting identification of the precise site of insertion of the muscular ventricular septum relative to the atrioventricular junction. This made it possiblefirst, to calculate the degree of valvar override, and second, to predict the location of the penetrating atrioventricular bundle. End-diastolic volume of the right ventricle in those with straddling tricuspid valves was 73 (61–83)% of normal, and, of the left ventricle in those with mitral valvar straddling 71 (40‐97)% of normal.

Conclusions

3D echocardiography can aid in planning the optimal surgical procedure in patients with straddling or overrriding atrioventricular valves, as it provides diagnostic information superiorto standard crosssectional techniques. It also allows for exact measurement of the volumes of the respective ventricles.

Keywords

3D echocardiographycross sectional echocardiographystraddling atrioventricular valves
Type
Original Articles
Information
Cardiology in the Young , Volume 10 , Issue 6 , November 2000 , pp. 603 - 609
Copyright
Copyright © Cambridge University Press 2000

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