3D transesophageal echocardiographic visualization of the pulmonary artery catheter through the tricuspid valve and their position relative to the tricuspid valve leaflets

• Published in: JA clinical reports Vol. 10; no. 1; pp. 35 - 6
• Main Authors: Takada, Shoko, Fujimoto, Tomoko, Tomita-Kobayashi, Akiko, Hayashi, Yukio
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 30.05.2024; Springer Nature B.V; SpringerOpen
• Subjects: 3-Dimensional transesophageal echocardiography; Anesthesiology; Catheters; Clinical Research Article; Critical Care Medicine; Emergency Medicine; Intensive; Medicine; Medicine & Public Health; Pain Medicine; Pulmonary arteries; Pulmonary artery catheter; Tricuspid valve; 3-Dimensional transesophageal echocardiography; Tricuspid valve; Pulmonary artery catheter
• ISSN: 2363-9024; 2363-9024
• DOI: 10.1186/s40981-024-00718-z

Background The tricuspid valve is an atrioventricular valve consisting of three lobes. We used the 3D transesophageal echocardiography to visualize position of the pulmonary artery catheter at the tricuspid valve annulus and examined where the catheter passed through at the level of the tricuspid annulus. Methods In this prospective and observational study, we monitored the pressure wave on patients undergoing cardiac surgery with the catheter placement by monitoring the pressure waveform for 8 months. We measured the time required for the catheter to pass through the tricuspid and pulmonary valves, respectively. We acquired the 3D image of the tricuspid valve by transesophageal echocardiography and determined the position of the pulmonary artery catheter at the level of the tricuspid annulus. The data were analyzed by Kruskal-Wallis test followed by Mann-Whitney test with Holm multiple comparisons. P < 0.05 was considered significant. Results Of the 116 cases, the pulmonary artery catheter passed through the tricuspid valve between antero-posterior leaflets in 78 cases (67.2 %), between septal-posterior leaflets in 25 cases (21.6 %), and between antero-septal leaflets in 2 cases (1.7 %) and the center in 11 cases (9.5 %), respectively. The time required for the catheter to pass through the pulmonary valves was significantly different among the catheter positions at the level of the tricuspid annulus. Conclusion The pulmonary artery catheter location at the level of the tricuspid annulus can be identified using 3D transesophageal echocardiography. The location of the catheter significantly affects the pulmonary artery catheter placement time.