Document Detail

Tricuspid Annulus: A Three-Dimensional Deconstruction and Reconstruction.
MedLine Citation:
PMID:  25249160     Owner:  NLM     Status:  Publisher    
BACKGROUND: Before clinical manifestation of regurgitation, the tricuspid annulus dilates and flattens when right ventricular dysfunction is potentially reversible. That makes the case for a prophylactic tricuspid annuloplasty even in the absence of significant tricuspid regurgitation. Owing to the appreciation of the favorable prognostic value of tricuspid annuloplasty, the geometry of the normal tricuspid annulus merits critical analysis.
METHODS: Three-dimensional transesophageal echocardiographic data from 26 patients were analyzed using Image Arena (TomTec, Munich, Germany) software. Cartesian coordinate data from tricuspid annuli were exported to MATLAB (Mathworks, Natick, MA) for further processing. Annular metrics related to size, shape, and motion were computed.
RESULTS: The tricuspid annulus demonstrated significant changes in area (p < 0.01) and perimeter (p < 0.03) during the cardiac cycle, with maximum values attained at end diastole. There was significant correlation between two- and three-dimensional area changes, indicating true expansion in the annulus. The anterolateral region of the annulus demonstrated the greatest dynamism (p < 0.01), and the anteroseptal region showed the least. The anteroseptal region also displayed the most nonplanarity in the annulus. In addition, vertical translational motion was observed, with a mean distance of 11.3 ± 3.7 mm between end systolic and end diastolic annular centroids.
CONCLUSIONS: The tricuspid annulus is a dynamic, multiplanar structure with heterogeneous regional behavior. These characteristics should be taken into account for optimal annuloplasty device design and efficacy.
Khurram Owais; Charles E Taylor; Luyang Jiang; Kamal R Khabbaz; Mario Montealegre-Gallegos; Robina Matyal; Joseph H Gorman; Robert C Gorman; Feroze Mahmood
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-9-20
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  -     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2014 Sep 
Date Detail:
Created Date:  2014-9-24     Completed Date:  -     Revised Date:  2014-9-25    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2014 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
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