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Non-Circular Shape of Right Ventricular Outflow Tract: A Real-Time Three-Dimensional Transesophageal Echocardiography Study.
MedLine Citation:
PMID:  22891043     Owner:  NLM     Status:  Publisher    
BACKGROUND: -The shape of right ventricular outflow tract (RVOT) has been assumed to be circular. The aim of this study was to assess RVOT morphology using three-dimensional transesophageal echocardiography (3D TEE). METHODS AND RESULTS: -This prospective study included 114 patients who underwent 3D TEE. Two-dimensional (2D) TEE measured maximum and minimum RVOT diameters (RVOTD max and min) during a cardiac cycle. 3D TEE determined RVOT area (RVOTA) max and min, RVOT fractional area change, and RVOT shape index (RVOTSI; vertical / horizontal RVOTD). Cardiac output (CO) was calculated using 2D TEE, 3D TEE, and a Swan-Ganz catheter in 23 patients. All patients were classified into group 1 (RVOTSI ≤1) or group 2 (RVOTSI >1) based on the RVOT shapes. The mean RVOTSIs were 0.84 ± 0.21(max) and 0.82 ± 0.20 (min). Only 17 patients (14.9%) had circular RVOT (RVOTSI: 0.95-1.05); 82 patients (71.9%) were categorized into group 1 and 32 patients (28.1%) into group 2. 2D TEE, compared with 3D TEE, underestimated RVOTA max and min (both P<0.001). CO with 3D TEE had better agreement with CO with a catheter than CO with 2D TEE (r=0.83 and 0.53, respectively). CONCLUSIONS: -3D TEE revealed that RVOT geometry was not generally circular but oval with 2 different types. Because of the detailed morphological information of RVOT, 3D TEE could provide more accurate assessment of CO than 2D TEE.
Masaki Izumo; Maiko Shiota; Takeji Saitoh; Eiji Kuwahara; Yoko Fukuoka; Swaminatha V Gurudevan; Kirsten Tolstrup; Robert J Siegel; Takahiro Shiota
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-8-13
Journal Detail:
Title:  Circulation. Cardiovascular imaging     Volume:  -     ISSN:  1942-0080     ISO Abbreviation:  Circ Cardiovasc Imaging     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-8-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101479935     Medline TA:  Circ Cardiovasc Imaging     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
1 The Heart Institute at Cedars-Sinai Medical Center, Los Angeles, CA;
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