DIAGNOSTIC INCREASE BY DETERMINING RIGHT- VENTRICULAR SYSTOLIC PRESSURE WITH BIPLANE TRANSESOPHAGEAL ECHOCARDIOGRAPHY

In the course of a prospective trial including 150 patients examined w ith transthoracic (TTE) as well as biplane transesophageal echocardiog raphy (TEE), tricuspid valve regurgitation was found and quantified de finitively on transthoracic examination in 41 cases, and on transesoph ageal examination in 42 cases. Comparison of these two ultrasound tech niques revealed that tricuspid valve regurgitation was only quantifiab le by TEE in 4 cases, and only by TTE in 3 cases. In 38 cases, however , ''quantifiable'' differences of pressure proven between the right at rium and the right ventricle were found to agree in the transthoracic and transesophageal examination runs. Regression was r = 0.95 in the 3 8 cases. Coefficient of determination = 0.9. Biplane transesophageal e chocardiography provides a reliable estimate of systolic pressure in t he right ventricle. In general, the TEE technique does not provide add itional diagnostic information in patients easily examined by using th e precordial technique. Whenever transthoracic examination leads to un exact or no results in the determination of right ventricular systolic pressure, due to anatomic reasons, a biplane or multiplane transesoph ageal technique should be considered.