Feasibility of pulmonary valve imaging using transesophageal echocardiography upper esophageal view.

Authors:
Tuncay Taskesen
Tuncay Taskesen
Dicle University Medical Faculty Department of Cardiology
Turkey
Somnath J Prabhu
Somnath J Prabhu
University of Washington
United States
Donald Oxorn
Donald Oxorn
University of Washington Medical Center
United States
Edward A Gill
Edward A Gill
University of Washington School of Medicine

Echocardiography 2019 May 19;36(5):930-937. Epub 2019 Apr 19.

Division of Cardiology, University of Colorado School of Medicine, Aurora, Colorado.

Background: The present study designed to evaluate feasibility of transesophageal echocardiographic (TEE) imaging of the pulmonary valve (PV) at the transaortic upper esophageal (TAUE) window. We hypothesized that patients with larger aorta would be more likely to have visualization of the PV from this TAUE window.

Methods: 2D TEE images of the PV were prospectively acquired by one operator at the TAUE window looking through the aortic arch. Patients were divided into four groups based on image quality of PV (group 1, not visualized; group 2, barely visualized; group 3, sufficient visualization; group 4, excellent visualization). Clinical, echocardiographic, and radiologic parameters were collected.

Results: A total of 212 consecutive patients (54 ± 14 years, 63.7% male) were enrolled. Group distribution was as follows: group 1, n = 60 (28.3%); group 2 n = 39 (18.4%); group 3, n = 27 (12.7%); group 4, n = 86 (40.6%). There were no differences between groups' baseline clinical characteristics. There was a weak although statistically negative correlation between PV image quality and aortic arch dimension (r = -0.17 P = 0.01). There was a stronger positive correlation between PV thickness (r = 0.38 P < 0.001) and PV image quality. Retrospective subgroup analysis of 76 patients with recent chest CT showed similar, but not significant trends as by TEE.

Conclusion: The use of 2D TEE TAUE results in diagnostic image quality of the PV in the majority of patients and outstanding image quality in a subset of patients. PV image quality is negatively affected by increasing aorta diameter and positively affected by PV thickness.

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Source
https://onlinelibrary.wiley.com/doi/abs/10.1111/echo.14332
Publisher Site
http://dx.doi.org/10.1111/echo.14332DOI Listing
May 2019
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