Right ventricular volume determination by two-dimensional echocardiography.

Right ventricular (RV) volume was calculated by two-dimensional echocardiography (2DE) using a subxiphoidal approach in 31 patients with congenital heart disease. Using 2DE, two views which were equivalent to the frontal and lateral views of RV angiocardiograms were obtained. Frontal view was defined as the plane which included the apex of RV, pulmonary and tricuspid valves. Lateral view was also defined as the frame which included the round shaped left ventricle, pulmonary and mitral valves, RV cavity was traced in both views, and subsequently, two area outlines were combined to calculate volumes by the biplane area-length (AL) and Simpson's rule (Simpson) methods. RV volumes were also determined by angiocardiography (ACG) using Simpson's rule method. In some patients, considerable limitations were noted such as, loss of echoes from the RV free wall, unusual and excess echoes from the left ventricle in RV cavity. Tracing of RV cavity was sometimes difficult because of the thickened RV myocardium or difficult recognition of the pulmonary valve. The correlation between RV volume by 2DE and that by ACG was good (r = 0.86 by AL method, r = 0.85 by Simpson) but not satisfactory for the clinical application. We conclude that RV volume is estimated from 2DE, but further investigations are required for this technique to be an accurate and a reliable means in the clinical practice.