Abstract: Objective To investigate the diagnostic value of preoperative real-time three-dimensional color Doppler transthoracic echocardiography on assessment of patients with structural heart disease (SHD). Methods A total of 111 patients were assessed preoperatively using real-time three-dimensional color Doppler transthoracic echocardiography (RT-3D-CDTTE), which include 31 SHD patients and 80 patients without SHD that were designed as negative control.Conventional two-dimensional color Doppler transthoracic echocardiography (2D-CDTTE) were used to compared with RT- 3DCDTTE while cardiovascular angiography and intraoperative findings were used as“Golden Standard”simultaneously. First of all, preoperative echocardiographic examination were performed and diagnosis was given. Angiography and intraoperative findings were hired to verify the accuracy of echocardiographic diagnosis before operation. Results (1) The preoperative RT-3D-CDTTE displayed three-dimensional structure and hemodynamic status of SHD cardiac lesions clearly, which were consistent with cardiovascular angiography and intraoperative findings. (2) P value of McNemar test between 2D- CDTTE and“Golden Standard”was greater than 0.05, Kappa=0.654 (P < 0.001). P value of McNemar test between RT-3D-CDTTE and“Golden Standard”was greater than 0.05, Kappa=0.932 (P < 0.001). Conclusion RT-3D-CDTTE can provides essential information for preoperative evaluation which is important for decision of SHD management.

Key words: echocardiography, three-dimensional, hemodynamics, transthoracic echocardiography, structural heart disease, preoperative evaluation