title: Evaluation of tricuspid and pulmonary valves using epicardial and transesophageal echocardiography--a comparative study.
abstract: OBJECTIVE
  To compare measurements obtained by transesophageal echocardiography (TEE) and epicardial echocardiography (EE) for evaluation of the tricuspid valve (TV) and pulmonary valve (PV).
  
  
  METHODS
  Prospective observational.
  
  
  METHODS
  University hospital.
  
  
  METHODS
  Patients undergoing elective coronary artery bypass grafting with or without aortic valve replacement.
  
  
  METHODS
  After routine intraoperative TEE, EE was performed to compare measurements obtained by the 2 methods.
  
  
  RESULTS
  After institutional review board approval, 25 patients >18 years old were recruited. Biases with EE versus TEE for E and A waves were 11.9 cm/second (95% confidence interval [CI], 48.2 to -24.4) and 6.8 cm/second (95% CI, 28 to -15), respectively, and for E/A ratio was 0.08 (95% CI, 1.2 to -1). Pulmonary velocity bias was 57.94 cm/second (95% CI, 192.9 to -76.98), with higher values using EE. Bias for pulmonary trunk diameter was -0.31 cm (95% CI, 1.5 to -2.1). For quality of images, means were 2.4 (standard deviation [SD], 1.0) for EE and 2.3 (SD, 0.57) with TEE for TV and 2.4 (SD, 1.0) with EE and 2.5 (SD, 1.0) with TEE for PV. For the number of leaflets visualized, means were 2.2 (SD, 1.0) with EE and 2.5 (SD, 0.5) with TEE for TV and 2.5 (SD, 0.5) for EE and 1.3 (SD, 1.1) with TEE for PV.
  
  
  CONCLUSIONS
  There was good agreement for Doppler measurements across TVs; however, measurements across PVs were significantly higher with EE versus TEE. TV Doppler measurements were difficult to acquire even for surgeons experienced in epiaortic scanning.
authors: Department of Anesthesia, Thompson General Hospital, Burntwood Regional Health Authority, Thompson, Manitoba, Canada. drravibabu19@yahoo.com
authors: Ravi B
authors: RB
authors: Kumbharathi
authors: Ravi
authors: R
authors: Taneja
authors: Rishi
authors: R
authors: Mehra
authors: Mackenzie A
authors: MA
authors: Quantz
authors: Lin R
authors: LR
authors: Guo
authors: Daniel T
authors: DT
authors: Bainbridge
mesh_terms: D000368:Aged; D001026:Coronary Artery Bypass / Q000295:instrumentation / Q000592:standards; D017548:Echocardiography, Transesophageal / Q000295:instrumentation* / Q000592:standards*; D006801:Humans; D010496:Pericardium / Q000000981:diagnostic imaging* / Q000601:surgery; D011446:Prospective Studies; D011664:Pulmonary Valve / Q000000981:diagnostic imaging* / Q000601:surgery; D014261:Tricuspid Valve / Q000000981:diagnostic imaging* / Q000601:surgery