TY - JOUR
T1 - Accuracy and reproducibility of aortic annular measurements obtained from echocardiographic 3D manual and semi-automated software analyses in patients referred for transcatheter aortic valve implantation
T2 - Implication for prosthesis size selection
AU - Stella, Stefano
AU - Italia, Leonardo
AU - Geremia, Giulia
AU - Rosa, Isabella
AU - Ancona, Francesco
AU - Marini, Claudia
AU - Capogrosso, Cristina
AU - Giglio, Manuela
AU - Montorfano, Matteo
AU - Latib, Azeem
AU - Margonato, Alberto
AU - Colombo, Antonio
AU - Agricola, Eustachio
N1 - Publisher Copyright:
© 2018. For permissions.
PY - 2019/1/1
Y1 - 2019/1/1
N2 - Transcatheter aortic valve implantation (TAVI) is nowadays an alternative therapeutic option in patients with severe symptomatic aortic stenosis (AS) at high or intermediate surgical risk or with contraindication to surgery.1,2 Accurate imaging assessment of the aortic valve annulus (AA) is critical for prosthesis sizing. Several imaging techniques have been used for this purpose.3-5 2D echocardiographic images allow the analysis of the annulus diameter in just one view (sagittal plane) and may underestimate the maximal valve annulus diameter.6 Multislice computed tomography (MSCT) achieved a central role in the preprocedural planning providing also information about the degree of valve calcification and the morphology of the access routes.7 3D transoesophageal echocardiography (3D-TOE) is a safe procedure that does not require iodinated contrast and may constitute a valuable imaging tool during TAVI, providing accurate measurements of the aortic root and geometry. Recent studies suggest that the annulus measurements using 3D-TOE images closely approximate those of MSCT.8,9 3D-TOE reconstruction tools have recently been introduced, which automatically configures a geometric model of the aortic root from the images obtained by 3D-TOE and perform quantitative analyses of the AA.10 However, the accuracy of these methods compared with the standard imaging techniques has not been completely evaluated yet. The aims of this study were: (i) to compare the measurements of the AA obtained by semi-automated quantitative modelling of the root from 3D-TOE data to those obtained by 3D-TOE manual analysis and by MSCT as the 'gold standard'; (ii) to determine agreements between 3D-TOE manual, semi-automated, and MSCT-derived AA measurements; and (iii) to assess the reproducibility of themethods.
AB - Transcatheter aortic valve implantation (TAVI) is nowadays an alternative therapeutic option in patients with severe symptomatic aortic stenosis (AS) at high or intermediate surgical risk or with contraindication to surgery.1,2 Accurate imaging assessment of the aortic valve annulus (AA) is critical for prosthesis sizing. Several imaging techniques have been used for this purpose.3-5 2D echocardiographic images allow the analysis of the annulus diameter in just one view (sagittal plane) and may underestimate the maximal valve annulus diameter.6 Multislice computed tomography (MSCT) achieved a central role in the preprocedural planning providing also information about the degree of valve calcification and the morphology of the access routes.7 3D transoesophageal echocardiography (3D-TOE) is a safe procedure that does not require iodinated contrast and may constitute a valuable imaging tool during TAVI, providing accurate measurements of the aortic root and geometry. Recent studies suggest that the annulus measurements using 3D-TOE images closely approximate those of MSCT.8,9 3D-TOE reconstruction tools have recently been introduced, which automatically configures a geometric model of the aortic root from the images obtained by 3D-TOE and perform quantitative analyses of the AA.10 However, the accuracy of these methods compared with the standard imaging techniques has not been completely evaluated yet. The aims of this study were: (i) to compare the measurements of the AA obtained by semi-automated quantitative modelling of the root from 3D-TOE data to those obtained by 3D-TOE manual analysis and by MSCT as the 'gold standard'; (ii) to determine agreements between 3D-TOE manual, semi-automated, and MSCT-derived AA measurements; and (iii) to assess the reproducibility of themethods.
KW - 3D echocardiographic semi-automated software
KW - 3D transoesophageal echocardiography
KW - aortic annular sizing
KW - transcatheter aortic valve replacement
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U2 - 10.1093/ehjci/jey013
DO - 10.1093/ehjci/jey013
M3 - Article
C2 - 29420710
AN - SCOPUS:85058923204
SN - 2047-2404
VL - 20
SP - 45
EP - 55
JO - European Heart Journal Cardiovascular Imaging
JF - European Heart Journal Cardiovascular Imaging
IS - 1
ER -