TRANSESOPHAGEAL ECHOCARDIOGRAPHIC ASSESSMENT OF LESIONS OF THE RIGHT-VENTRICULAR OUTFLOW TRACT AND PULMONIC VALVE

To establish the role of biplane transesophageal echocardiography (TEE ) in the assessment of congenital and acquired lesions involving the r ight ventricular outflow tract (RVOT) and pulmonic valve (PV), 28 cons ecutive RVOT and PV lesions in 22 consecutive patients were studied by two-dimensional and color Doppler transthoracic echocardiograms (n = 22), horizontal (n = 22) and vertical (n = 22) plane TEEs, cardiac cat heterization (n = 15), cardiac surgery (n = 6), and magnetic resonance imaging (n = 1). Sixteen patients had congenital lesions, and sit had acquired Lesions. Longitudinal TEE clearly imaged 25 of 28 abnormalit ies, transverse TEE clearly imaged 12 of 28, and transthoracic echocar diography clearly imaged 9 of 28. Two-dimensional TEE scanning reveale d the Lesion or site of stenosis. Color Doppler revealed conspicuous m osaic jets in relation to a structural abnormality in most cases. Long itudinal TEE was more sensitive in the detection of small vegetations of the PV, in the depiction of PV doming in cases of valvar pulmonic s tenosis, and in the display of the RVOT and PV so that the longitudina l extent of involvement of larger masses could be appreciated. However , longitudinal TEE was not able to assess the gradient of a stenosis a t the RVOT or PV level in any case. Biplane TEE is helpful in, the ana tomic assessment of congenital and acquired lesions of the RVOT and PV in adults.