Tomoko Umazume MD, Presenter: Nothing to Disclose

Nobusada Funabashi MD, PhD, Abstract Co-Author: Nothing to Disclose

Akihisa Kataoka MD, Abstract Co-Author: Nothing to Disclose

Hiroyuki Takaoka MD, PhD, Abstract Co-Author: Nothing to Disclose

Masae Uehara MD, Abstract Co-Author: Nothing to Disclose

Koya Ozawa MD, Abstract Co-Author: Nothing to Disclose

Masashi Kabasawa MD, Abstract Co-Author: Nothing to Disclose

Hiroki Kohno MD, Abstract Co-Author: Nothing to Disclose

Goro Matsumiya MD, PhD, Abstract Co-Author: Nothing to Disclose

Yoshio Kobayashi, Abstract Co-Author: Nothing to Disclose

The accurate pre operative estimation of tricuspid valve (TV) annular diameter (TVAD) is important for surgical TV plasty in right heart failure. To evaluate utility of 320 slice CT for pre operative evaluation of TVAD, we compared those with TVAD by a transthorasic echocardiogram (TTE) before TVP, regarded direct measurement of TVAD during operation (TVADope) as references.

21 consecutive TV plasty patients (11 males, 68.0±8.0 yrs; 6 with mitral valve plasty, 4 with mitral valve replacement and each three with aortic valve replacement or mitral annuloplasty) underwent retrospective electrocardiogram (ECG) gated enhanced 320 slice CT (Aquilion One, Toshiba Medical) and TTE (IE33, Philips) just before TVP. CT images were reconstructed for 0-95% of ECG R-R intervals at 5% intervals. To reproduce same conditions as surgery, phase of widest TV opening was selected and TVAD in axial images and TVAD in multiplanar reconstruction images generated from axial images were measured and their sum was taken as TVAD on CT (TVADct). Maximum TVAD on TTE (TVADtte) were calculated on apical 4 chamber views. Direct measurement of TVADope (sum of anterosuperior, septal, and inferior leaflet lengths) was made during surgery when TV was fully open.

TVADct and TVADtte, TVADope were 110.5±20.0, 39.9±6.5, and 44.0±7.6 mm, respectivley. Correlation coefficients for TVADope with TVADct and TVAtte were 0.52 and 0.49, respectively.

TVADct was significantly positively correlated with direct measurement of TVADope slightly better than TVADtte. TVADope can be predicted by TVADct.

Size of TVAD is most influenced by RAV. Measurement of RAV by CT accurately may be important before planning surgical operation of tricuspid valve annuloplasty for right heart failure.

Umazume, T, Funabashi, N, Kataoka, A, Takaoka, H, Uehara, M, Ozawa, K, Kabasawa, M, Kohno, H, Matsumiya, G, Kobayashi, Y, Preoperative Measurements of Tricuspid Valve Annular Diameter by 320-Slice CT Was Superior to a Transthorasic Echocardiogram for the Accurate Prediction of Direct Measurement of Tricuspid Valve Annular Diameter during Open Heart Surgery.  Radiological Society of North America 2012 Scientific Assembly and Annual Meeting, November 25 - November 30, 2012 ,Chicago IL. http://archive.rsna.org/2012/12035542.html