Feasibility of Pulmonary Valve Imaging Using Three-Dimensional Transthoracic Echocardiography

Background: The pulmonary valve (PV) is rarely visualized in short axis with conventional two-dimensional transthoracic echocardiography (TTE). Thus, the true incidence of abnormal PV morphology in patients undergoing TTE is unknown. This study sought to evaluate the feasibility of using three-dimensional echocardiography in the morphologic assessment of the PV in short-axis. Methods: A total of 200 consecutive patients referred for routine TTE were prospectively evaluated (mean age 64 +/- 16 years; 113 males). Live3D and full-volume 3D (FV3D) were performed with the feasibility of visualizing PV morphology assessed. McNemar's test was used as a nonparametric comparator between Live3D and FV3D results and to assess for any significant learning curve. Chi-square test was used to determine the association between variables. Results: PV morphology detection rates were significantly different (P < .0001) between Live3D (60%) and FV3D (23%). The optimal plane for Live3D was the parasternal view (99%), using zoom over the PV and rotating to a short-axis image. PV short-axis cusp detection using Live3D was dependent on the initial two-dimensional PV image quality (P < .0001). Conclusion: Live3D is feasible in evaluating PV short-axis morphology and provides incremental value in the TTE examination. (J Am Soc Echocardiogr 2010;23:1076-80.)