Tricuspid Annulus: A Three-Dimensional Deconstruction and Reconstruction

Owais, Khurram; Taylor, Charles; Jiang, Luyang; Khabbaz, Kamal R.; Montealegre-Gallegos, Mario; Matyal, Robina; Gorman, Joseph H.; Gorman, Robert C.; Mahmood, Feroze

doi:10.1016/j.athoracsur.2014.07.005

Cited by 35 publications

(22 citation statements)

References 20 publications

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“…6,7 The volumetric nature of 3D data facilitates accurate linear and volumetric calculations without any geometric assumptions. Specifically, 3D imaging has demonstrated value in quantitative analyses of structural heart diseases 6,7,14,15 and hemodynamic calculations as well. 16,17 Recently, 3D echocardiographic data have been used for 3D printing of intracardiac structures.…”

Section: Discussionmentioning

confidence: 99%

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Cardiac Imaging—3-Dimensional Echocardiography

Saraf¹,

Mahmood

2016

International Anesthesiology Clinics

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Section: Discussionmentioning

confidence: 99%

“…[6][7][8] Any of the 3D imaging modes can be used to visualize the tricuspid valve from the right atrial and right ventricular (RV) perspective (Fig. 15).…”

Section: Qualitative Imagingmentioning

confidence: 99%

Cardiac Imaging—3-Dimensional Echocardiography

Saraf¹,

Mahmood

2016

International Anesthesiology Clinics

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“…The most comprehensive study on human tricuspid annular shape and dynamics was published by Fukuda and colleagues using 3D echocardiography . While essentially reconfirming basic data on annular size and size changes throughout the cardiac cycle, they demonstrate a clear change in annular height between systole and diastole, thus contradicting Hiro et al while corroborating the findings of Chandra et al Also, using 3D echocardiography, Kwan et al, Ring et al, Owais et al, and Nishi et al and other groups made similar observations.…”

Section: Dynamics Of the Tricuspid Annulusmentioning

confidence: 99%

Biomechanics of the tricuspid annulus: A review of the annulus' in vivo dynamics with emphasis on ovine data

2019

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The tricuspid annulus forms the boundary between the tricuspid valve leaflets and their surrounding perivalvular tissue of the right atrioventricular junction. Its shape changes throughout the cardiac cycle in response to the forces from the contracting right heart myocardium and the blood‐valve interaction. Alterations to annular shape and dynamics in disease lead to valvular dysfunctions such as tricuspid regurgitation from which millions of patients suffer. Successful treatment of such dysfunction requires an in‐depth understanding of the normal shape and dynamics of the tricuspid annulus and of the changes following disease and subsequent repair. In this manuscript we review what we know about the shape and dynamics of the normal tricuspid annulus and about the effects of both disease and repair based on noninvasive imaging studies and invasive fiduciary marker‐based studies. We further show, by means of ovine data, that detailed engineering analyses of the tricuspid annulus provide regionally resolved insight into the kinematics of the annulus which would remain hidden if limiting analyses to simple geometric metrics.

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“…Despite the increased appreciation of the tricuspid annulus (TA) geometry in recent years,[ 1 2 3 ] there are still gaps in understanding its dynamism over the course of the cardiac cycle and identifying the axes of maximal dynamism. The lack of correlation between TA dilation and severity of tricuspid regurgitation (TR) could possibly be due to the discrepancy between the echocardiographically appreciated, i.e., septolateral (S-L) axis, and the true anatomical axis of dynamism.…”

Section: Introductionmentioning

confidence: 99%

Tricuspid annulus: A spatial and temporal analysis

et al. 2016

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Background:Traditional two-dimensional (2D) echocardiographic evaluation of tricuspid annulus (TA) dilation is based on single-frame measurements of the septolateral (S-L) dimension. This may not represent either the axis or the extent of dynamism through the entire cardiac cycle. In this study, we used real-time 3D transesophageal echocardiography (TEE) to analyze geometric changes in multiple axes of the TA throughout the cardiac cycle in patients without right ventricular abnormalities.Materials and Methods:R-wave-gated 3D TEE images of the TA were acquired in 39 patients undergoing cardiovascular surgery. The patients with abnormal right ventricular/tricuspid structure or function were excluded from the study. For each patient, eight points along the TA were traced in the 3D dataset and used to reconstruct the TA at four stages of the cardiac cycle (end- and mid-systole, end- and mid-diastole). Statistical analyses were applied to determine whether TA area, perimeter, axes, and planarity changed significantly over each stage of the cardiac cycle.Results:TA area (P = 0.012) and perimeter (P = 0.024) both changed significantly over the cardiac cycle. Of all the axes, only the posterolateral-anteroseptal demonstrated significant dynamism (P < 0.001). There was also a significant displacement in the vertical axis between the points and the regression plane in end-systole (P < 0.001), mid-diastole (P = 0.014), and mid-systole (P < 0.001).Conclusions:The TA demonstrates selective dynamism over the cardiac cycle, and its axis of maximal dynamism is different from the axis (S-L) that is routinely measured with 2D TEE.

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Tricuspid Annulus: A Three-Dimensional Deconstruction and Reconstruction

Abstract: The tricuspid annulus is a dynamic, multiplanar structure with heterogeneous regional behavior. These characteristics should be taken into account for optimal annuloplasty device design and efficacy.

Cited by 35 publications

References 20 publications

Cardiac Imaging—3-Dimensional Echocardiography

Cardiac Imaging—3-Dimensional Echocardiography

Biomechanics of the tricuspid annulus: A review of the annulus' in vivo dynamics with emphasis on ovine data

Tricuspid annulus: A spatial and temporal analysis

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