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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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References

1. Milo, S, Ho, SY, Macartney, FJ, Wilkinson, JL, Becker, AE,Gittenberger-de, Groot AC, Anderson, RH. Straddling and overriding atrioventricular valves, morphology and classification. Am J Cardiol 1979;44: 1122–1134.CrossRefGoogle Scholar
2. Pacifico, AD, Soto, B, Bargeron, LM jrSurgical treatment of straddling tricuspid valves. Circulation 1979;60: 655–664.Google Scholar
3. Anderson, RH. Surgical repair of straddling and overriding tricuspid valve. Cardiol Young 1997; 7: 122–128.Google Scholar
4. Hagler, DJ, Tajik, AJ, Seward, JB, Mair, DD, Ritter, DG. Double outlet right ventricle: Wide-angle two-dimensional echocardiographic observations. Circulation 1981;63: 419–428CrossRefGoogle ScholarPubMed
5. Vogel, M, Ho, SY, Bühlmeyer, K, Anderson, RH. Assessment of congenital heart defects by dynamic three-dimensional echocardiography: Methods of data acquisition and clinical utility. Acta Paediatnca 1995; Supplement 410: 34–39.Google Scholar
6. Ludomirsky, A, Vermillion, R, Nesser, J, Marx, G, Vogel, M,Derman, R, Pandian, N. Transthoracic real-time three-dimensional echocardiography using rotational scanning approach for data-acquisition. Echocardiography 1994,11: 599–606.Google Scholar
7. Vogel, M, Löosch, SDynamic three-dimensional echocardiography with a computed imaging probe: Initial clinical experience with transthoracic application in infants and children with congenital heart defects. Br Heart J 1994;71: 462–67.CrossRefGoogle ScholarPubMed
8. Pandian, NG, Roelandt, J, Nanda, NC, Sugeng, L, Cao, Q-L,Azevedo, J, Schwartz, S, Vannan, M, Ludomirsky, A, Marx, G, Vogel, M. Dynamic three-dimensional echocardiography: Methods and clinical potential. Echocardiography 1994;11: 237–259.Google Scholar
9. Vogel, M, White, P, Redington, A. In vitro validation of right ventricular volume measurement by 3D echocardiography. Br Heart J 1995;74: 460–463.Google Scholar
10. Buck, Th, Schon, F, Baumgart, D, Leischik, R, Schappert, Th,Kupferwasser, I, Meyer, J, Gorge, G, Haude, M, Erbel, R. Tomographic left ventricular volume determination in the presence of aneurysm by three-dimensional echocardiographic imaging. I: asymmetric model hearts. J Am Soc Echocardiogr 1996;9: 488–500.Google Scholar
11. Helbing, WA, Rebergen, SA, Maliepaard, C, Hansen, B,Ottenkamp, J, Reiber, JHC, de Roos, A.Quantification of right ventricular function with magnetic resonance imaging in children with normal hearts and with congenital heart disease. Am Heart J 1995;130: 828–837.Google Scholar
12. Graham, TP jrJarkamani, JM, Canent, RV, Morrow, MN. Left heart volume estimation in infancy and childhood. Circulation 1971;43: 895–904.CrossRefGoogle ScholarPubMed
13. Helbing, WA, Bosch, HG, Maliepaard, C, Rebergen, SA, van der Geest, RJ, Hansen, B, Ottenkamp, J, Reiber, JHC, de Roos, AComparison of echocardiographic methods with magnetic resonance imaging for assessment of right ventricular function inchildren. Am J Cardiol 1995;76: 589–594.Google Scholar
14. Vogel, M, Gutberlet, M, Dittrich, S, Hosten, N, Lange, PE. Comparison of magnetic resonance imaging and 3D echocardiography in the in vivo assessment of RV volume and mass. Heart 1997;78: 127–130.Google Scholar
15. Wenink, AC, Gittenberger-de Groot, AC.Straddling mitral and tricuspid valves: morphologic differences and developmental background. Am J Cardiol 1982;49: 1959–1971.Google Scholar
16. Rice, MJ, Seward, JB, Edwards, WD. Straddling atrioventncular valve: two-dimensional echocardiographic diagnosis, classification and surgical implications. Am J Cardiol 1985;55: 506–513.CrossRefGoogle ScholarPubMed
17. Aziz, KU, Paul, MH, Muster, AJ, Idriss, FS. Positional abnormalities of atrioventncular valves in transposition of the great arteries including double outlet right ventricle, atrioventricular valve straddlingandmalattachment. Am J Cardiol 1979;44: 1135–1145.Google Scholar
18. Tabry, IF, McGoon, DC, Danielson, GK, Wallace, WR, Tajik, AJ,Seward, JB. Surgical management of straddling atrioventricular valve. J Thorac Cardiovasc Surg 1979;77: 191–201.CrossRefGoogle ScholarPubMed
19. Reddy, VM, Liddicoat, JR, McElhinney, DB, Brook, MM, van Son, JAM, Hanley, FL. Biventncular repair of lesions with straddling tricuspid valves using techniques of cordal translocation and realignment. Cardiol Young 1997,7: 7–152.CrossRefGoogle Scholar
20. Vogel, M, Ho, SY, Lincoln, C, Yacoub, MH, Anderson, RH. Threedimensional echocardiography can simulate intraoperative visualization of congenitally malformed hearts. Ann Thorac Surg 1995;60: 1282–1288CrossRefGoogle ScholarPubMed
21. Vogel, M, Sauer, U, Bühlmeyer, K, Sebening, F. Atrioventricularseptal defect complicated by right ventricular outflow tract obstruction. Analysis of risk factors regardingsurgical repair. J Cardiovasc Surg 1989;30: 34–39.Google Scholar
22. Fisher, EA, Doshi, M, Bubrow, JWEffect of palliative and corrective surgery on ventricular volumesin complete atrioventricular canal. Pediatr Cardiol 1984;5: 159–166.Google Scholar
23. Huhta, JC, Edwards, WD, Danielson, GK, Feldt, RH. Abnormalities of the tricuspid valve in complete transposition of the great arteries with ventricular septal defect. J Thorac Cardiovasc Surg 1982;83.569–576.Google Scholar
24. Acar, P, Maunoury, C, Antonietti, T, Bonnet, D, Sidi, D, Kachaner, J. Left ventricular ejection fraction in children measured by three-dimensional echocardiogaphy using a new transthoracic integrated 3D-probe.A comparison with equilibrium radionuchde angiogaphy. Eur Heart J 1998;19: 1583–1588.Google Scholar
25. Ota, T, Fleishman, CE, Strub, M, Stetten, G, Ohazama, CJ, Ramm, von OT, Kisslo, J. Real-time, three-dimensional echocardiogrphy:Feasibility of dynamic right ventricular volume measurement with saline contrast. Am Heart J 1999,137: 137–967.CrossRefGoogle Scholar
26. Vogel, M, Ho, SY, Anderson, RH, Redington, AN. Transthoracic 3D echocardiography in the assessment of subaortic stenosis due to a restrictive ventricular septal defect in double inlet left ventricle with discordant ventriculoarterial connections. Cardiol Young 1999;9: 552–558.CrossRefGoogle ScholarPubMed