Beatriz Vaquerizo1, Marco Spaziano2, Juwairia Alali2, Darren Mylote3, Pascal Theriault-Lauzier2, Rashed Alfagih2, Giuseppe Martucci2, Jean Buithieu2, Nicolo Piazza2. 1. Department of Medicine, Division of Interventional Cardiology, McGill University Health Center, 1001 Decarie Boulevard, Montreal, QC H3A 3J1, Canada Interventional Cardiology Unit, Cardiology Department, Hospital de la Santa Creu i Sant Pau, Barcelone, Spain beavaquerizo@yahoo.es. 2. Department of Medicine, Division of Interventional Cardiology, McGill University Health Center, 1001 Decarie Boulevard, Montreal, QC H3A 3J1, Canada. 3. Department of Medicine, Division of Interventional Cardiology, McGill University Health Center, 1001 Decarie Boulevard, Montreal, QC H3A 3J1, Canada University Hospital Galway, Galway, Ireland.
Abstract
AIMS: The accuracy of transcatheter aortic valve replacement (TAVR) sizing using three-dimensional transoesophageal echocardiography (3D-TEE) compared with the gold-standard multi-slice computed tomography (MSCT) remains unclear. We compare aortic annulus measurements assessed using these two imaging modalities. METHODS AND RESULTS: We performed a single-centre prospective cohort study, including 53 consecutive patients undergoing TAVR, who had both MSCT and 3D-TEE for aortic annulus sizing. Aortic annular dimensions, expected transcatheter heart valve (THV) oversizing, and hypothetical valve size selection based on CT and TEE were compared. 3D-TEE and CT cross-sectional mean diameter (r = 0.69), perimeter (r = 0.70), and area (r = 0.67) were moderately to highly correlated (all P-values <0.0001). 3D-TEE-derived measurements were significantly smaller compared with MSCT: perimeter (68.6 ± 5.9 vs. 75.1 ± 5.7 mm, respectively; P < 0.0001); area (345.6 ± 64.5 vs. 426.9 ± 68.9 mm(2), respectively; P < 0.0001). The percentage difference between 3D-TEE and MSCT measurements was around 9%. Agreement between MSCT- and 3D-TEE-based THV sizing (perimeter) occurred in 44% of patients. Using the 3D-TEE perimeter annular measurements, up to 50% of patients would have received an inappropriate valve size according to manufacturer-recommended, area-derived sizing algorithms. CONCLUSION: Aortic annulus measurements for pre-procedural TAVR assessment by 3D-TEE are significantly smaller than MSCT. In this study, such discrepancy would have resulted in up to 50% of all patients receiving the wrong THV size. 3D-TEE should be used for TAVR sizing, only when MSCT is not available or contraindicated. The clinical impact of this information requires further study. Published on behalf of the European Society of Cardiology. All rights reserved.
AIMS: The accuracy of transcatheter aortic valve replacement (TAVR) sizing using three-dimensional transoesophageal echocardiography (3D-TEE) compared with the gold-standard multi-slice computed tomography (MSCT) remains unclear. We compare aortic annulus measurements assessed using these two imaging modalities. METHODS AND RESULTS: We performed a single-centre prospective cohort study, including 53 consecutive patients undergoing TAVR, who had both MSCT and 3D-TEE for aortic annulus sizing. Aortic annular dimensions, expected transcatheter heart valve (THV) oversizing, and hypothetical valve size selection based on CT and TEE were compared. 3D-TEE and CT cross-sectional mean diameter (r = 0.69), perimeter (r = 0.70), and area (r = 0.67) were moderately to highly correlated (all P-values <0.0001). 3D-TEE-derived measurements were significantly smaller compared with MSCT: perimeter (68.6 ± 5.9 vs. 75.1 ± 5.7 mm, respectively; P < 0.0001); area (345.6 ± 64.5 vs. 426.9 ± 68.9 mm(2), respectively; P < 0.0001). The percentage difference between 3D-TEE and MSCT measurements was around 9%. Agreement between MSCT- and 3D-TEE-based THV sizing (perimeter) occurred in 44% of patients. Using the 3D-TEE perimeter annular measurements, up to 50% of patients would have received an inappropriate valve size according to manufacturer-recommended, area-derived sizing algorithms. CONCLUSION: Aortic annulus measurements for pre-procedural TAVR assessment by 3D-TEE are significantly smaller than MSCT. In this study, such discrepancy would have resulted in up to 50% of all patients receiving the wrong THV size. 3D-TEE should be used for TAVR sizing, only when MSCT is not available or contraindicated. The clinical impact of this information requires further study. Published on behalf of the European Society of Cardiology. All rights reserved.
Authors: Pascal Theriault-Lauzier; Hind Alsosaimi; Negareh Mousavi; Jean Buithieu; Marco Spaziano; Giuseppe Martucci; James Brophy; Nicolo Piazza Journal: Int J Comput Assist Radiol Surg Date: 2020-03-04 Impact factor: 2.924
Authors: Nadja Wystub; Laura Bäz; Sven Möbius-Winkler; Tudor C Pörner; Björn Goebel; Ali Hamadanchi; Torsten Doenst; Julia Grimm; Lukas Lehmkuhl; Ulf Teichgräber; P Christian Schulze; Marcus Franz Journal: Clin Res Cardiol Date: 2019-04-10 Impact factor: 5.460