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Two-dimensional transesophageal echocardiography for aortic annular sizing in patients undergoing transcatheter aortic valve implantation.

Sherif MA, Ince H, Maniuc O, Reiter T, Voelker W, Ertl G, Öner A - BMC Cardiovasc Disord (2015)

Bottom Line: Accurate preoperative assessment of the aortic annulus dimension is crucial for successful transcatheter aortic valve implantation (TAVI).CT remanis the gold standard in sizing of the aortic valve annulus.Nevertheless, sizing of the aortic valve annulus using TEE derived area may be helpful.

View Article: PubMed Central - PubMed

Affiliation: Internal Medicine Centre, Cardiology Department, Rostock University Clinic, Ernst-Hyedemann- Street 6, 18057, Rostock, Germany. mohammad_sherif@hotmail.com.

ABSTRACT

Background: Accurate preoperative assessment of the aortic annulus dimension is crucial for successful transcatheter aortic valve implantation (TAVI). In this study we examined the accuracy of a novel method using two-dimensional transesophageal echocardiography (2D-TEE) for measurement of the aortic annulus.

Methods: We evaluated the theoretical impact of the measurement of the annulus diameter and area using the circumcircle of a triangle method on the decision to perform the procedure and choice of the prosthesis size.

Results: Sixty-three consecutive patients were scheduled for TAVI. Mean age was 82 ± 4 years, and 25 patients (55.6 %) were female. Mean aortic annulus diameter was 20.3 ± 2.2 mm assessed by TEE on the mid-esophageal long-axis view and 23.9 ± 2.3 mm using CT (p < 0.001). There was a tendency for the TEE derived areas using the new method to be higher (p < 0.001). The TEE measurements were on average 42.33 mm(2) higher than the CT measurements without an evidence of a systematic over- or under-sizing (p = 1.00). Agreement between TEE and CT chosen valve sizes was good overall (kappa = 0.67 and weighted kappa = 0.71). For patients who turned out to have no AR, the two methods agreed in 84.6 % of patients.

Conclusions: CT remanis the gold standard in sizing of the aortic valve annulus. Nevertheless, sizing of the aortic valve annulus using TEE derived area may be helpful. The impact of integration of this method in the algorithm of aortic annulus sizing on the outcome of patients undergoing TAVI should be examined in future studies.

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The Bland-Altman plot of the difference (TEE derived area minus CT derived area) against the mean area of TEE and CT. The red dotted lines show the range of differences between the measurements for most (about 95 %) of individuals
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Fig6: The Bland-Altman plot of the difference (TEE derived area minus CT derived area) against the mean area of TEE and CT. The red dotted lines show the range of differences between the measurements for most (about 95 %) of individuals

Mentions: The Bland-Altman plot of the difference (TEE derived area minus CT derived area) against the mean area by TEE and CT is shown in Fig. 6. The red dotted lines show the range of differences between the measurements for most (about 95 %) of individuals.Fig. 6


Two-dimensional transesophageal echocardiography for aortic annular sizing in patients undergoing transcatheter aortic valve implantation.

Sherif MA, Ince H, Maniuc O, Reiter T, Voelker W, Ertl G, Öner A - BMC Cardiovasc Disord (2015)

The Bland-Altman plot of the difference (TEE derived area minus CT derived area) against the mean area of TEE and CT. The red dotted lines show the range of differences between the measurements for most (about 95 %) of individuals
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4696347&req=5

Fig6: The Bland-Altman plot of the difference (TEE derived area minus CT derived area) against the mean area of TEE and CT. The red dotted lines show the range of differences between the measurements for most (about 95 %) of individuals
Mentions: The Bland-Altman plot of the difference (TEE derived area minus CT derived area) against the mean area by TEE and CT is shown in Fig. 6. The red dotted lines show the range of differences between the measurements for most (about 95 %) of individuals.Fig. 6

Bottom Line: Accurate preoperative assessment of the aortic annulus dimension is crucial for successful transcatheter aortic valve implantation (TAVI).CT remanis the gold standard in sizing of the aortic valve annulus.Nevertheless, sizing of the aortic valve annulus using TEE derived area may be helpful.

View Article: PubMed Central - PubMed

Affiliation: Internal Medicine Centre, Cardiology Department, Rostock University Clinic, Ernst-Hyedemann- Street 6, 18057, Rostock, Germany. mohammad_sherif@hotmail.com.

ABSTRACT

Background: Accurate preoperative assessment of the aortic annulus dimension is crucial for successful transcatheter aortic valve implantation (TAVI). In this study we examined the accuracy of a novel method using two-dimensional transesophageal echocardiography (2D-TEE) for measurement of the aortic annulus.

Methods: We evaluated the theoretical impact of the measurement of the annulus diameter and area using the circumcircle of a triangle method on the decision to perform the procedure and choice of the prosthesis size.

Results: Sixty-three consecutive patients were scheduled for TAVI. Mean age was 82 ± 4 years, and 25 patients (55.6 %) were female. Mean aortic annulus diameter was 20.3 ± 2.2 mm assessed by TEE on the mid-esophageal long-axis view and 23.9 ± 2.3 mm using CT (p < 0.001). There was a tendency for the TEE derived areas using the new method to be higher (p < 0.001). The TEE measurements were on average 42.33 mm(2) higher than the CT measurements without an evidence of a systematic over- or under-sizing (p = 1.00). Agreement between TEE and CT chosen valve sizes was good overall (kappa = 0.67 and weighted kappa = 0.71). For patients who turned out to have no AR, the two methods agreed in 84.6 % of patients.

Conclusions: CT remanis the gold standard in sizing of the aortic valve annulus. Nevertheless, sizing of the aortic valve annulus using TEE derived area may be helpful. The impact of integration of this method in the algorithm of aortic annulus sizing on the outcome of patients undergoing TAVI should be examined in future studies.

Show MeSH