Key result
Three-dimensional echocardiography revealed that patients with repaired tetralogy of Fallot have significantly smaller posterior-septal tricuspid valve coaptation heights compared to healthy controls (16.7 vs 22.2 mm, p<0.001).
Why the study?
Tricuspid valve anomalies are linked to worsened prognosis in CHD, prompting this evaluation of TV morphology in repaired tetralogy of Fallot and hypoplastic left heart syndrome using 3D echocardiography.
Does three-dimensional echocardiography identify differences in tricuspid valve morphology in patients with repaired tetralogy of Fallot and hypoplastic left heart syndrome compared to controls?
Cross-Sectional (n=160)
Does three-dimensional echocardiography identify differences in tricuspid valve morphology in patients with repaired tetralogy of Fallot and hypoplastic left heart syndrome compared to controls?
Absolute Event Rate: 16.7% vs 22.2%
p-value: p=<0.001
3D echocardiography is feasible for assessing tricuspid valve morphology in congenital heart disease and identifies distinct structural differences in rTOF and HLHS compared to controls.
Supports 3D echocardiography feasibility for tricuspid assessment in congenital heart disease; leaves open clinical implications of reduced coaptation in repaired tetralogy of Fallot.
Anomalies of the tricuspid valve (TV) are associated with worsened prognosis in congenital heart disease (CHD). Here, we present a descriptive study examining changes in TV morphology in two CHD conditions-repaired tetralogy of Fallot (rTOF) and hypoplastic left heart syndrome (HLSH), using three-dimensional echocardiography. Full volume acquisitions of the TV and right ventricle (RV) were performed from an RV-focused apical view using ECG gating over 2-5 consecutive cardiac cycles using 3D echocardiography, from which TV annulus and leaflet parameters were quantified. A total of 40 rTOF patients (age 14 ± 9.8 years), 40 HLHS patients (age1.0 ± 1.5 years) and 80 age and gender matched controls were included. Among leaflet parameters, antero-posterior and posterior-septal TV coaptation heights were smaller in rTOF (p < 0.001) vs. control. Conversely, only the short-axis TV height was different in HLHS vs. controls (HLHS 1.6 ± 0.4 cm vs. control 1.4 ± 0.3 cm). TV leaflet parameters tended to be larger in HLHS, while leaflet coaptation distances were similar between groups. We demonstrate that 3D echocardiography for assessment of the TV is feasible in rTOF and HLHS patients and identifies unique differences in TV morphology. Future studies should clarify the clinical significance of TV morphology in these patient populations.
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Jani et al. (2023) conducted a cross-sectional in Repaired tetralogy of Fallot and hypoplastic left heart syndrome (n=160). Repaired tetralogy of Fallot and Hypoplastic left heart syndrome vs. Age and gender-matched healthy controls was evaluated on Posterior-septal tricuspid valve coaptation height (mm) (p=<0.001). Three-dimensional echocardiography revealed that patients with repaired tetralogy of Fallot have significantly smaller posterior-septal tricuspid valve coaptation heights compared to healthy controls (16.7 vs 22.2 mm, p<0.001).
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