Three-dimensional echocardiography of right heart pathology

Three-dimensional (3-D) echocardiography uses sequentially acquired tomogra phy echocardiographic data, which is gated to the cardiac cycle, to reconst ruct 3-D views of the heart. So far, this technique has been used primarily to evaluate left-sided heart structures. This report focuses on congenital and acquired right-sided heart pathologies that have been visualized by 3- D echocardiography. In addition to reviewing the literature, several repres entative figures are included illustrating the unique ability of 3-D echo t o elucidate complex right heart anatomy. After a brief introduction to the technical aspects of 3-D echocardiography, the discussion centers on evalua tion of congenital heart disease and right-sided masses, determination of r ight ventricular mass and volume, and evaluation of right-sided valvular he art disease. Congenital heart diseases that are reviewed include atrial sep tal defect (location, size, efficacy, of repair), ventricular septal defect , and congenital heart disease in the fetus being evaluated in utero. Evalu ation of right-sided masses, including tumors, vegetations, and thrombi, is reviewed. Methods of determining right ventricular volume and mass using 3 -D Echo are discussed. Evaluation of valvular heart disease, including Dopp ler analysis of regurgitant flow, is examined. Finally, special attention i s given to the perioperative and intraoperative use of 3-D echocardiography for patients with these conditions. The conclusion summarizes the current and potential future uses of 3-D echocardiography.