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: Implication for prosthesis size selection

Stefano Stella, Leonardo Italia, Giulia Geremia, Isabella Rosa, Francesco Ancona, Claudia Marini, Cristina Capogrosso, Manuela Giglio, Matteo Montorfano, Azeem Latib, Alberto Margonato, Antonio Colombo, Eustachio Agricola

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)45-55
Number of pages11
JournalEuropean Heart Journal Cardiovascular Imaging
Volume20
Issue number1
DOIs
StatePublished - Jan 1 2019
Externally publishedYes

Keywords

  • 3D echocardiographic semi-automated software
  • 3D transoesophageal echocardiography
  • aortic annular sizing
  • transcatheter aortic valve replacement

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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