Abstract 15505: New Assessment of Tricuspid Annular Dilatation in Patients with Tricuspid Regurgitation by Three-Dimensional Transesophageal Echocardiography
Background: Tricuspid valve (TV) annuloplasty is a common surgical strategy for tricuspid regurgitation (TR), but it is difficult to evaluate TV before surgery using two-dimensional echocardiography. Three-dimensional transesophageal echocardiography (3D TEE) was recently developed to provide superior image quality and accurate morphology of TV. The purpose of this study was to evaluate the relationship between tricuspid annular dilatation (TAD) and TR by 3D TEE.
Methods: 3D TEE (iE33; Philips) was performed in 81 patients with TR. Tricuspid annular area (TAA), 3 intercommissural distances (ICD) (anterior, posterior, and septal ICD) and septal intercommissural height (ICH) were measured at late systolic phase using QLAB software (figure 1). TR (grade 0-4) was assessed by color Doppler echocardiography and patients were classified into three groups [group: TR0 (n=53), group: TR1-2 (n=20), group: TR3-4 (n=8)].
Results: (1) TAA in group: TR3-4 was significantly larger compared with that in group: TR0, group: TR1-2 (18.8±4.62mm2 vs 11.3±3.0mm2, 11.8±3.47mm2 p<0.001, figure 2). (2) Each ICD was significantly correlated with TAA (anterior ICD; r2=0.71, posterior ICD; r2=0.56, septal ICD; r2=0.61, p<0.001, respectively), and especially anterior ICD had the best correlation with TAA (figure 3). (3) Septal ICH in group: TR3-4 was significantly larger compared with that in group: TR0, group: TR1-2 (3.16±0.38mm vs 2.38±0.49mm, 2.48±0.62mm p<0.001, figure 4).
Conclusions: These results suggested that TAD might be associated with TR grade and tricuspid annulus might be dilated toward the free wall of the right ventricle and anterior ICD might be a simple and effective index for the assessment of TAD.
- © 2011 by American Heart Association, Inc.