In order to provide an approach for quantitative evaluation of right ventricular outflow tract (RVOT) and right ventricular (RV) size and function in patients (pts) with postoperative tetralogy of Fallot (T/F), we explored the accuracy of multiplane transesophageal echocardiography (TEE) in 17 pts aged 13-52 years. 34 pts were in sinus rhythm and 7 were in atrial fibrillation. A thorough esophageal, low esophageal and transgastric scanning was performed. When scanning transesophageal four-chamber views, RV body was demonstrated and fractional area change calculated. Using a sweep of esophageal longitudinal plane images, the entire right ventricular outflow tract was visualized and evaluated in detail. Expanded transgastric imaging allowed for a good alignment to flow within the RVOT, thus enabling the accurate calculation of pressure gradients. The ratio of pulmonary insufficiency (PI) jet width measured by color Doppler to the infundibulum diameter was used to quantify the severity of PI (ratio >50% = moderate to severe PI). Ten pts had normal or nearly normal RV size. 4 pts presented with severely dilated RV and decreased fractional area change for progressive pulmonary insufficiency due to an outflow patch. 1 pt presented with RV dilation plus moderate to severe tricuspid insufficiency, and 2 pts demonstrated stenosis and insufficiency of previously placed conduit valves. These study findings indicate the utility of a complete multiplane transesophageal echocardiographic assessment in adolescent and adult pts after repair of T/F. Since pulmonary valve replacement is frequently considered for pts with progressive PI and severe RV dilation or a second valve replacement for dysfunctioning conduits, multiplane TEE is recommended to assess morphofunctional details especially when transthoracic images are limited by paucity of acoustic windows.

MULTIPLANE TRANSESOPHAGEAL ECHOCARDIOGRAPHIC ASSESSMENT OF RIGHT VENTRICULAR SIZE AND FUNCTION POST REPAIR OF TETRALOGIA OF FALLOT / Vitarelli, Antonino; Caselli, A; Conde, Y; Giubilei, R; DI BENEDETTO, G; Lamura, A; Leone, T; Giordani, E; Cimino, E; Fedele, Francesco. - In: EUROPEAN JOURNAL OF ECHOCARDIOGRAPHY. - ISSN 1525-2167. - STAMPA. - 1(SUPPL. 2):(2000), p. S66. (Intervento presentato al convegno EUROECHO 4 tenutosi a Lisbon, Portugal nel 6-9 Dec. 2000).

MULTIPLANE TRANSESOPHAGEAL ECHOCARDIOGRAPHIC ASSESSMENT OF RIGHT VENTRICULAR SIZE AND FUNCTION POST REPAIR OF TETRALOGIA OF FALLOT

VITARELLI, Antonino;FEDELE, Francesco
2000

Abstract

In order to provide an approach for quantitative evaluation of right ventricular outflow tract (RVOT) and right ventricular (RV) size and function in patients (pts) with postoperative tetralogy of Fallot (T/F), we explored the accuracy of multiplane transesophageal echocardiography (TEE) in 17 pts aged 13-52 years. 34 pts were in sinus rhythm and 7 were in atrial fibrillation. A thorough esophageal, low esophageal and transgastric scanning was performed. When scanning transesophageal four-chamber views, RV body was demonstrated and fractional area change calculated. Using a sweep of esophageal longitudinal plane images, the entire right ventricular outflow tract was visualized and evaluated in detail. Expanded transgastric imaging allowed for a good alignment to flow within the RVOT, thus enabling the accurate calculation of pressure gradients. The ratio of pulmonary insufficiency (PI) jet width measured by color Doppler to the infundibulum diameter was used to quantify the severity of PI (ratio >50% = moderate to severe PI). Ten pts had normal or nearly normal RV size. 4 pts presented with severely dilated RV and decreased fractional area change for progressive pulmonary insufficiency due to an outflow patch. 1 pt presented with RV dilation plus moderate to severe tricuspid insufficiency, and 2 pts demonstrated stenosis and insufficiency of previously placed conduit valves. These study findings indicate the utility of a complete multiplane transesophageal echocardiographic assessment in adolescent and adult pts after repair of T/F. Since pulmonary valve replacement is frequently considered for pts with progressive PI and severe RV dilation or a second valve replacement for dysfunctioning conduits, multiplane TEE is recommended to assess morphofunctional details especially when transthoracic images are limited by paucity of acoustic windows.
2000
EUROECHO 4
04 Pubblicazione in atti di convegno::04c Atto di convegno in rivista
MULTIPLANE TRANSESOPHAGEAL ECHOCARDIOGRAPHIC ASSESSMENT OF RIGHT VENTRICULAR SIZE AND FUNCTION POST REPAIR OF TETRALOGIA OF FALLOT / Vitarelli, Antonino; Caselli, A; Conde, Y; Giubilei, R; DI BENEDETTO, G; Lamura, A; Leone, T; Giordani, E; Cimino, E; Fedele, Francesco. - In: EUROPEAN JOURNAL OF ECHOCARDIOGRAPHY. - ISSN 1525-2167. - STAMPA. - 1(SUPPL. 2):(2000), p. S66. (Intervento presentato al convegno EUROECHO 4 tenutosi a Lisbon, Portugal nel 6-9 Dec. 2000).
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/191984
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