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3D echocardiography: an innovation to assess right heart?

ESC Congress Report

  • Images should be displayed in a way that is familiar to Interventional Cardiologists and Electrophysiologists who are used to looking at Fluoro images.
  • 3D Echo can identify the mechanism of tricuspid regurgitant in patients with pacing wire induced TR.
  • 2D and 3D Echo are complementary.
  • Future uses of 3D speckle tracking.


View the Slides from this session in ESC Congress 365

3D Echocardiography has been widely discussed as a technique to assess the left ventricle and the left side heart valves. In this session, Chaired by myself (Prof. Mark Monaghan) and Prof. Manni Vannan (Atlanta, US) it was refreshing to hear 4 expert presenters focus on the applications of 3D in the right heart.

Dr. Fausto Rigo started the session with an excellent presentation on right atrial anatomy and function which was superbly illustrated with high-quality 3D images demonstrating excellent correlation between true anatomy and 3D images. Dr Rigo explained the important anatomical features relevant for structural interventions and EP and he highlighted the need to display images in a way that would be familiar to Interventional Cardiologists and Electrophysiologists who are used to looking at Fluoro images.

Dr. Moya Mur presented next on the tricuspid valve and he explained how inadequately this structure is seen on 2D Echo. The added value of 3D Echo in evaluating a range of tricuspid valve pathologies, including carcinoid was very well demonstrated. In addition, he highlighted the important role that 3D Echo can play in identifying the mechanism of tricuspid regurgitant in patients with pacing wire induced TR. This is not infrequent and it appears that 3D Echo can nicely demonstrate how the position of the wire across the tricuspid valve can cause regurgitation.

Prof. Partho Segupta (New York, US) gave the next presentation on assessing the normal right ventricle. This talk was outstanding and he elegantly explained the different anatomical features of the RV, how they all contribute to RV function and the strengths and weaknesses of 3D in assessing this chamber. He brought home the message that 2D and 3D Echo are really complementary in this context. His presentation generated a lot of interest and many questions from the audience.

The last presentation was given by Prof. Petros Nihoyannopoulos from Imperial College. He has published extensively on the role of Echo in assessing RV dysfunction so it seemed entirely appropriate that he should deliver this talk on using 3D. He gave fascinating insight into how 3D speckle tracking, may in the future, be used to clinically assess the RV, in the same way as it is currently used in the LV. This generated a stimulating discussion about the merits of including the ventricular septum in strain analysis of the RV and how the concept of ventricular interdependence influences the functional parameters we are using.

All in all, this was a well attended session which generated a lot of discussion, questions from the audience and very positive feedback. The general consensus was that we want more sessions in the future on 3D Echo and the right heart.

References


Session 983

SessionTitle: 3D echocardiography: an innovation to assess right heart?

The content of this article reflects the personal opinion of the author/s and is not necessarily the official position of the European Society of Cardiology.