Visibility of Pulmonary Valve and Pulmonary Regurgitation on Intracardiac Echocardiography in Adult Patients with Tetralogy of Fallot

Pulmonary regurgitation (PR) is a risk factor for sudden cardiac death in adult patients with repaired tetralogy of Fallot (TOF). However, transthoracic echocardiography (TTE) cannot fully visualize the pulmonary valve (PV) and PR. We investigated whether intracardiac echocardiography (ICE) could vi...

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Main Authors: Ichiro Sakamoto, Kenichiro Yamamura, Ayako Ishikita, Kisho Ohtani, Shintaro Umemoto, Hidetaka Kaku, Yuzo Yamasaki, Kohtaro Abe, Tomomi Ide, Hiroyuki Tsutsui
Format: Article
Language:English
Published: MDPI AG 2023-01-01
Series:Journal of Cardiovascular Development and Disease
Subjects:
Online Access:https://www.mdpi.com/2308-3425/10/1/24
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author Ichiro Sakamoto
Kenichiro Yamamura
Ayako Ishikita
Kisho Ohtani
Shintaro Umemoto
Hidetaka Kaku
Yuzo Yamasaki
Kohtaro Abe
Tomomi Ide
Hiroyuki Tsutsui
author_facet Ichiro Sakamoto
Kenichiro Yamamura
Ayako Ishikita
Kisho Ohtani
Shintaro Umemoto
Hidetaka Kaku
Yuzo Yamasaki
Kohtaro Abe
Tomomi Ide
Hiroyuki Tsutsui
author_sort Ichiro Sakamoto
collection DOAJ
description Pulmonary regurgitation (PR) is a risk factor for sudden cardiac death in adult patients with repaired tetralogy of Fallot (TOF). However, transthoracic echocardiography (TTE) cannot fully visualize the pulmonary valve (PV) and PR. We investigated whether intracardiac echocardiography (ICE) could visualize the PV and PR better than TTE. Thirty adult patients with TOF (mean age 33 ± 15 years) scheduled for cardiac catheterization underwent ICE. The visualization of PV and the severity of PR were classified into three grades. ICE depicted the PV better than TTE (ICE vs. TTE: not visualized, partially visualized, and fully visualized: <i>n</i> = 1 [3%], <i>n</i> = 13 [43%], and <i>n</i> = 16 [53%] vs. <i>n</i> = 14 [47%], <i>n</i> = 13 [43%], and <i>n</i> = 3 [10%], <i>p</i> < 0.001). Especially in patients after pulmonary valve replacement (PVR), the PV was more fully visualized by ICE. The assessment of PR by TTE underestimated the severity of PR in comparison to cardiac magnetic resonance imaging (MRI) (severe PR: 8 [28%] vs. 22 [76%], <i>p</i> = 0.004), while there was no discrepancy between the results of ICE and MRI (21 [72%] vs. 22 [76%], <i>p</i> = 1.000). In comparison to TTE, ICE can safely provide better visualization of the PV and PR in adults with TOF, especially in patients who have undergone PVR.
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spelling doaj.art-7e8e8489d95a49b5ac8675ff814f0cc42023-11-30T22:49:16ZengMDPI AGJournal of Cardiovascular Development and Disease2308-34252023-01-011012410.3390/jcdd10010024Visibility of Pulmonary Valve and Pulmonary Regurgitation on Intracardiac Echocardiography in Adult Patients with Tetralogy of FallotIchiro Sakamoto0Kenichiro Yamamura1Ayako Ishikita2Kisho Ohtani3Shintaro Umemoto4Hidetaka Kaku5Yuzo Yamasaki6Kohtaro Abe7Tomomi Ide8Hiroyuki Tsutsui9Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, JapanDepartment of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, JapanDepartment of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, JapanDepartment of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, JapanDepartment of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, JapanDepartment of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, JapanDepartment of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, JapanDepartment of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, JapanDepartment of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, JapanDepartment of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, JapanPulmonary regurgitation (PR) is a risk factor for sudden cardiac death in adult patients with repaired tetralogy of Fallot (TOF). However, transthoracic echocardiography (TTE) cannot fully visualize the pulmonary valve (PV) and PR. We investigated whether intracardiac echocardiography (ICE) could visualize the PV and PR better than TTE. Thirty adult patients with TOF (mean age 33 ± 15 years) scheduled for cardiac catheterization underwent ICE. The visualization of PV and the severity of PR were classified into three grades. ICE depicted the PV better than TTE (ICE vs. TTE: not visualized, partially visualized, and fully visualized: <i>n</i> = 1 [3%], <i>n</i> = 13 [43%], and <i>n</i> = 16 [53%] vs. <i>n</i> = 14 [47%], <i>n</i> = 13 [43%], and <i>n</i> = 3 [10%], <i>p</i> < 0.001). Especially in patients after pulmonary valve replacement (PVR), the PV was more fully visualized by ICE. The assessment of PR by TTE underestimated the severity of PR in comparison to cardiac magnetic resonance imaging (MRI) (severe PR: 8 [28%] vs. 22 [76%], <i>p</i> = 0.004), while there was no discrepancy between the results of ICE and MRI (21 [72%] vs. 22 [76%], <i>p</i> = 1.000). In comparison to TTE, ICE can safely provide better visualization of the PV and PR in adults with TOF, especially in patients who have undergone PVR.https://www.mdpi.com/2308-3425/10/1/24intracardiac echocardiographypulmonary valvepulmonary regurgitationtetralogy of Fallot
spellingShingle Ichiro Sakamoto
Kenichiro Yamamura
Ayako Ishikita
Kisho Ohtani
Shintaro Umemoto
Hidetaka Kaku
Yuzo Yamasaki
Kohtaro Abe
Tomomi Ide
Hiroyuki Tsutsui
Visibility of Pulmonary Valve and Pulmonary Regurgitation on Intracardiac Echocardiography in Adult Patients with Tetralogy of Fallot
Journal of Cardiovascular Development and Disease
intracardiac echocardiography
pulmonary valve
pulmonary regurgitation
tetralogy of Fallot
title Visibility of Pulmonary Valve and Pulmonary Regurgitation on Intracardiac Echocardiography in Adult Patients with Tetralogy of Fallot
title_full Visibility of Pulmonary Valve and Pulmonary Regurgitation on Intracardiac Echocardiography in Adult Patients with Tetralogy of Fallot
title_fullStr Visibility of Pulmonary Valve and Pulmonary Regurgitation on Intracardiac Echocardiography in Adult Patients with Tetralogy of Fallot
title_full_unstemmed Visibility of Pulmonary Valve and Pulmonary Regurgitation on Intracardiac Echocardiography in Adult Patients with Tetralogy of Fallot
title_short Visibility of Pulmonary Valve and Pulmonary Regurgitation on Intracardiac Echocardiography in Adult Patients with Tetralogy of Fallot
title_sort visibility of pulmonary valve and pulmonary regurgitation on intracardiac echocardiography in adult patients with tetralogy of fallot
topic intracardiac echocardiography
pulmonary valve
pulmonary regurgitation
tetralogy of Fallot
url https://www.mdpi.com/2308-3425/10/1/24
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