Evaluation of the tricuspid valve morphology and function by transthoracic real-time three-dimensional echocardiography

Assessment of tricuspid valve (TV) function plays an important role in a number of clinical disease states, including left-sided valve disease and heart failure. However, the TV is a complex structure that, unlike the aortic and mitral valve, it is not possible to visualize in one cross-sectional view using either transthoracic or transoesophageal two-dimensional echocardiography (i.e. imaging all three TV leaflets and their attachment in the annulus simultaneously). Conversely, three-dimensional echocardiography allows users to visualize the whole TV apparatus from any perspective. This may significantly improve our understanding of the pathophysiological mechanisms underlying the various TV diseases and functional tricuspid regurgitation, and potentially suggest ways to improve surgical treatment. This review details the current status of real-time three-dimensional echocardiography evaluation of TV morphology and function with its clinical applications and limitations.