ABSTRACT
Three-dimensional echocardiography (3D echo) is the most suited imaging technique for assessing heart valves, by integrating volumetric rendering with motion in real time. The rapidly advancing 3D echo technology allows us today to perform a virtual “dissection” of the heart intra vitam and to discover unprecedented, impressive views of cardiac valves in just few minutes. This is particularly true for the tricuspid valve (TV). In fact, despite two-dimensional echocardiography (2D echo) and Doppler imaging continue to be the standard methods to diagnose TV pathology and quantify its severity, several limitations inherent to 2D echo modality frequently preclude an accurate characterization of TV anatomy and function:
In contrast, 3D echo is especially suited for the assessment of the 3D confi guration of TV apparatus and the anatomic complexity of the right ventricle (RV)1,2 (see Chapter 4). Three-dimensional echocardiogra phy has unique capabilities to display en face the nonplanar TV leafl ets, annulus, the subvalvular apparatus, and their spatial relation ships with the surrounding structures.2,3 The complementary use of 3D color Doppler fl ow adds information about valve integrity and enables the quantitation of TV regurgitation. Preliminary evidence suggests that transthoracic 3D echo could probably become the reference technique to non invasively assess TV morphology and function in daily practice (Table 11.1).3
