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

BMC Cardiovascular Disorders

Research Article

Octavian Maniuc¹  Georg Ertl¹  Wolfram Voelker¹  Therese Reiter¹  Alper Öner²  Mohammad A. Sherif²  Hüseyin Ince² 

[1] I. Internal Medicine Clinic, Cardiology Department, Wuerzburg University Clinic, Wuerzburg, Germany;Internal Medicine Centre, Cardiology Department, Rostock University Clinic, Ernst-Hyedemann- Street 6, 18057, Rostock, Germany;

关键词: TAVI;    Sizing;    Echocardiography;   

DOI  :  10.1186/s12872-015-0181-3

 received in 2015-10-14, accepted in 2015-12-21,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundAccurate 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.MethodsWe 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.ResultsSixty-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 mm2 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.ConclusionsCT 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.

【 授权许可】

CC BY   
© Sherif et al. 2015