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European Journal of Echocardiography 2009 10(4):477-484; doi:10.1093/ejechocard/jep044
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2009. For permissions please email: journals.permissions@oxfordjournals.org

Evaluation of the tricuspid valve morphology and function by transthoracic real-time three-dimensional echocardiography

Luigi P. Badano1,*, Eustachio Agricola2, Leopoldo Perez de Isla3, Pasquale Gianfagna1 and Jose Louis Zamorano3

1 Echo-Lab, Department of Cardiopulmonary Sciences, University Hospital ‘S Maria della Misericordia’, P.le S Maria della Misericordia 15, 33100 Udine, Italy
2 Division of Noninvasive Cardiology, San Raffaele Hospital, Milan, Italy
3 Unidad de Imagen Cardiovascular, Instituto Cardiovascular—Hospital Clínico San Carlos, Madrid, Spain

Received 27 December 2008; accepted after revision 5 April 2009.

* Corresponding author. Tel: +39 0432 552444; fax: +39 0432 482353. E-mail address: badano.luigi{at}aoud.sanita.fvg.it; lbadan{at}tin.it


  Abstract

Assessment of tricuspid valve (TV) function plays an important role in a number of clinical disease states, including left-sided valve disease and heart failure. However, the TV is a complex structure that, unlike the aortic and mitral valve, it is not possible to visualize in one cross-sectional view using either transthoracic or transoesophageal two-dimensional echocardiography (i.e. imaging all three TV leaflets and their attachment in the annulus simultaneously). Conversely, three-dimensional echocardiography allows users to visualize the whole TV apparatus from any perspective. This may significantly improve our understanding of the pathophysiological mechanisms underlying the various TV diseases and functional tricuspid regurgitation, and potentially suggest ways to improve surgical treatment. This review details the current status of real-time three-dimensional echocardiography evaluation of TV morphology and function with its clinical applications and limitations.

Keywords: Echocardiography; Three-dimensional; Real-time; Tricuspid valve; Tricuspid insufficiency; Tricuspid stenosis; Tricuspid regurgitation; Surgery


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