In order to bring you the best possible user experience, this site uses Javascript. If you are seeing this message, it is likely that the Javascript option in your browser is disabled. For optimal viewing of this site, please ensure that Javascript is enabled for your browser.

The free consultation period for this content is over.

It is now only available year-round to EACVI Silver Members, Fellows of the ESC and Young combined Members

3D guided CT assessment to define the right pulmonary vein on standard apical 4-chamber view.

Session Poster session 3

Speaker Jasmine Chan

Congress : EuroEcho 2019

  • Topic : imaging
  • Sub-topic : Echocardiography
  • Session type : Poster Session
  • FP Number : P889

Authors : J Chan (Melbourne,AU), OH Mehta (Melbourne,AU), P Mottram (Melbourne,AU), IM Tay (Melbourne,AU), J Teng (Melbourne,AU)

J Chan1 , OH Mehta1 , P Mottram1 , IM Tay1 , J Teng1 , 1Monash Heart - Melbourne - Australia ,


Pulmonary vein(PV) assessment is an integral component of the transthoracic echocardiogram(TTE) examination; typically assessed in the apical four-chamber view(A4Ch). There is disagreement in current textbooks and literature regarding which specific right pulmonary vein is visualised on A4Ch; as either the right superior(RSPV) or right inferior PV(RIPV).
Given the high reliability of cardiac CT for PV assessment, we aimed to characterize right PV anatomy on A4Ch by utilizing multi-modality comparison of echocardiography and a 3D-guided A4Ch on CT.

Retrospective analysis was performed on consecutive patients with TTE demonstrating PV flow(by colour or pulse-wave Doppler) and cardiac CT within 30days; studies not meeting image quality criteria excluded. To simulate the A4Ch on CT, multi-planar reconstruction was used to create an image plane including right PV ostia and LV apex. This image was rotated along the long-axis to achieve an A4Ch with both ventricles and atria, tricuspid and mitral valves in view without LVOT or aorta. This was attempted for right superior, inferior and middle(RMPV, if present) PV’s.

50 patients were analysed: mean age 66yrs, 48% female, mean LA volume(indexed) 43.5ml/m². A4Ch was feasible in 100%(n=50) of CT simulations using the RIPV, only 24%(n=12) were feasible using RSPV with all excluded cases due to LVOT/aorta persistently in view. RMPV was present in 6 cases with feasible A4ch in 67%. 

This study demonstrates that the right PV on A4Ch is highly likely to be the RIPV due to the RSPV being anatomically impossible in the significant majority of cases.

Based on your interests

Members get more

Join now
  • 1ESC Professional Members – access all resources from ESC Congress and ESC Asia with APSC & AFC
  • 2ESC Association Members (Ivory, Silver, Gold) – access your Association’s congress resources
  • 3Under 40 or in training - with a Combined Membership, access resources from all congresses
Join now

Our sponsors

ESC 365 is supported by Bayer, Boehringer Ingelheim and Lilly Alliance, Bristol-Myers Squibb and Pfizer Alliance, Novartis Pharma AG and Vifor Pharma in the form of educational grants. The sponsors were not involved in the development of this platform and had no influence on its content.

logo esc

Our mission: To reduce the burden of cardiovascular disease

Who we are