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Updated: Jun 3, 2025
Morphological and Functional Assessment of the Right Ventricle Using 3D Echocardiography
Published on: October 28, 2020
Multimodality Imaging Evaluation of Diseases of the Pulmonic Valve and Right Ventricular Outflow Tract for the Adult
Seán P Murphy1,2, Sadia Sultana2, Emily K Zern3
1Division of Cardiology (S.P.M., A.T.-R., A.C.S.S., S.H., C.P.L., T.W.C., D.F.Y., E.Y.), Massachusetts General Hospital, Boston.
Insights
Pulmonic valve (PV) disease is often overlooked but serious. Early diagnosis using advanced imaging like echocardiography, CT, and MRI is crucial for timely treatment and better outcomes in adults with congenital heart disease.
Area of Science:
- Cardiology
- Medical Imaging
- Congenital Heart Disease
Background:
- Pulmonic valve (PV) disorders are under-recognized compared to other valvular heart diseases.
- Increased survival in congenital heart disease leads to a growing adult population requiring specialized care.
- Clinicians need expertise in evaluating right ventricular outflow tract and PV anomalies.
Purpose of the Study:
- To provide a comprehensive diagnostic approach for pulmonic valve disease.
- To highlight the role of multimodality imaging in evaluating PV and associated conditions.
- To improve patient outcomes through timely diagnosis and treatment optimization.
Main Methods:
- Utilizing a multimodality imaging approach.
- Integrating echocardiography, cardiac computed tomography (CT), and magnetic resonance imaging (MRI).
- Focusing on the right ventricular outflow tract, pulmonic valve, and supravalvular regions.
Main Results:
- A systematic review of diagnostic strategies for PV disease.
- Emphasis on the critical role of imaging in identifying subtle PV abnormalities.
- Demonstration of how imaging guides therapeutic strategies and post-procedural surveillance.
Conclusions:
- Timely diagnosis of PV disease is essential due to significant morbidity and mortality.
- A high index of suspicion and appropriate multimodality imaging are critical.
- Optimizing diagnosis and treatment through imaging enhances patient outcomes.
Abstract:
Disorders of the pulmonic valve (PV) receive considerably less attention than other forms of valvular heart disease. Due to the dramatically improved survival of children with congenital heart disease over the last 5 decades, there has been a steady increase in the prevalence of adults with congenital heart disease, which necessitates that clinicians become familiar with the anatomy and the evaluation of right ventricular outflow tract and PV anomalies. A multimodality imaging approach using echocardiography, cardiac computed tomography, and magnetic resonance imaging is essential for a comprehensive evaluation of the anatomy and function of the right ventricular outflow tract, PV, and supravalvular region. As clinical presentation is often insidious with nonspecific symptoms, yet morbidity and mortality associated with severe untreated PV disease are significant, a high index of suspicion coupled with appropriate use of imaging techniques is critical in facilitating timely diagnosis and treatment. In this review, we aim to present a comprehensive approach to the diagnosis of PV disease and associated right ventricular outflow tract or supravalvular pulmonary stenosis, including optimal use of multimodality imaging to facilitate timely diagnosis, optimize therapeutic strategies, enhance postprocedural surveillance, and ultimately improve patient outcomes.
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