The advantages of live/real time three-dimensional transesophageal echocardiography during assessments of pulmonary stenosis

  • Tuğba Kemaloğlu Öz
  • Fatma Özpamuk Karadeniz
  • Şükrü Akyüz
  • Şennur Ünal Dayı
  • Aycan Esen Zencirci
  • Işıl Atasoy
  • Altuğ Ösken
  • Mehmet Eren
Original Paper


This report sought to compare live/real-time three-dimensional transesophageal echocardiography (3D-TEE) with two-dimensional transesophageal echocardiography (2D-TEE) and to determine whether there are advantages to using 3D-TEE on patients with pulmonary stenosis (PS). Sixteen consecutive adult patients (50 % male and 50 % female; mean age 33 ± 13.4 years) with PS and indications of TEE were prospectively enrolled in this study. Following this, initial 2D-TEE and 3D-TEE examinations were performed, and 3D-TEE images were analyzed using an off-line Q-lab software system. Finally, the 2D-TEE and 3D-TEE findings were compared. In the present study, 3D-TEE allowed us to obtain the en face views of pulmonary valves (PVs) in all but one patient. While this patient was without a PV due to a previous tetralogy of Fallot operation, we could detect the type of PV in the other 15 (93.7 %) patients by using 3D-TEE. Due to poor image quality, the most stenotic area was not measurable in only one (6.2 %) of the patients. In eight (50 %) of the patients, severity and localization of stenosis were more precisely determined with 3DTEE than with 2D-TEE. The PVs’ maximal annulus dimensions were found to be significantly larger when they were measured using 3D modalities. This study provides evidence of the incremental value of using 3D-TEE rather than 2D-TEE during assessments of PS, specifically in cases where special conditions (pregnancy, pulmonary regurgitation, and concomitant atrial septal defects) cause recordings of the transvalvular peak gradient to be inaccurate. Therefore, 3D-TEE should be used as a complementary imaging tool to 2D-TEE during routine echocardiographic examinations.


Echocardiography Pulmonary valve Pulmonary valve stenosis Three-dimensional echocardiography Three dimensional transesophageal echocardiography Transesophageal echocardiography 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

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Supplementary material 2 (AVI 620 kb)

Supplementary material 3 (AVI 204 kb)


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Copyright information

© Springer Science+Business Media Dordrecht 2015

Authors and Affiliations

  • Tuğba Kemaloğlu Öz
    • 1
  • Fatma Özpamuk Karadeniz
    • 1
  • Şükrü Akyüz
    • 1
  • Şennur Ünal Dayı
    • 1
  • Aycan Esen Zencirci
    • 1
  • Işıl Atasoy
    • 1
  • Altuğ Ösken
    • 1
  • Mehmet Eren
    • 1
  1. 1.Cardiology DepartmentDr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research HospitalIstanbulTurkey

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