OR4. Agreement between Transthoracic Echocardiography and Surgical Measurements of the Tricuspid Annulus Diameter

The tricuspid annulus dilatation is an indication for tricuspid repair concomitant with mitral surgery. The distance between anteroseptal and anteroposterior commissure represents the direction of dilatation provided by surgical measurements. However, none of the standard views of two-dimensional transthoracic echocardiography (2D-TTE) intersect that plane and there is still a lack of study regarding the tricuspid annulus measurements by three-dimensional transthoracic echocardiography (3D-TTE). Therefore, this study aims to determine the agreement between the tricuspid annulus diameter measurement by transthoracic echocardiography and surgical measurement.

40 patients were included. Measurements of tricuspid annulus diameter by 2D-TTE and 3D-TTE were performed before surgery in parasternal right ventricle inflow (PRVI), parasternal short axis (PSAX), apical 4-chambers (A4C), and multiplanar analysis 3D-TTE views. Surgical measurements were performed during surgery. Agreement between the echocardiography and surgical measurements was analyzed using Bland-Altman and intraclass correlation analysis. Mean difference ± standard deviation (limits of agreement) and ICC of PRVI 2D-TTE vs surgical measurement were 1.35±5.02 mm (-8.48 - 11.18 mm), ICC 0.89, p < 0.001; PSAX 2D-TTE vs surgical measurement were 1.35±5.23 mm (-8.90 - 11.60 mm), ICC 0.88, p < 0.001; A4C 2D-TTE vs surgical measurement were 1.33±3.69 mm (-5.91 - 8.56 mm), ICC 0.93, p < 0.001; septolateral diameter 3D-TTE vs surgical measurements were 1.42±4.41 mm, (-7.22 - 10.06 mm), ICC 0.90, p < 0.001; anteroposterior diameter 3D-TTE vs surgical measurements were -2.695±7.43 mm (- 17.26 - 11.87 mm), ICC 0.68, p < 0.001.

A4C 2D-TTE and septolateral diameter 3D-TTE measurement have an excellent agreement with surgical measurement.