November 18, 2009Circulation Cardiovascular Imaging
Comparison of Aortic Root Dimensions and Geometries Before and After Transcatheter Aortic Valve Implantation by 2- and 3-Dimensional Transesophageal Echocardiography and Multislice Computed Tomography
Key result
Two- and 3-dimensional TEE significantly underestimated MSCT planimetered aortic annular areas before TAVI (e.g., 3D TEE planimetered 4.22±0.77 vs MSCT 4.65±0.82 cm2, P<0.001).
Why the study?
Do 2D and 3D TEE measurements of aortic annular and LVOT dimensions agree with MSCT in patients undergoing TAVI?
Population
Patients undergoing transcatheter aortic valve implantation (TAVI)
Comparison
2-dimensional and 3-dimensional transesophageal… vs Multislice computed tomography as the gold…
Design
Cohort
Follow-up
After TAVI
Authors
Discussion
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Implication
TEE annular measurements warrant caution for TAVI sizing; leaves open optimal multimodality integration in prospective validation.
Key Points
- This study aims to compare aortic annular and left ventricular outflow tract dimensions measured by 2D and 3D TEE with multislice computed tomography before and after TAVI.
- Compared 2D and 3D TEE measurements with MSCT planimetered areas before TAVI.
- Assessed changes in annular and LVOT areas after TAVI.
- Analyzed geometric agreements between imaging techniques for accuracy.
- Mean MSCT planimetered annular area was 4.65+/-0.82 cm² before TAVI; 2D TEE circular underestimated it at 3.89+/-0.74 cm² (P<0.001).
- After TAVI, MSCT planimetered annular areas decreased from 4.65+/-0.82 to 4.20+/-0.46 cm² (P<0.001).
- LVOT areas increased from 4.61+/-1.20 to 4.84+/-1.17 cm² (P=0.002) after TAVI.
Study Design
Type
Observational
Structured PICO
Do 2D and 3D TEE measurements of aortic annular and LVOT dimensions agree with MSCT in patients undergoing TAVI?
P
Population
Patients undergoing transcatheter aortic valve implantation (TAVI)
I
Intervention
2-dimensional and 3-dimensional transesophageal echocardiography (TEE)
C
Comparator
Multislice computed tomography (MSCT) as the gold standard
O
Outcome
Agreement between 2D and 3D TEE measurements with MSCT, and changes in annular/LVOT areas and geometries after TAVIsurrogate
Main Result
p-value: p=<0.001
3D TEE planimetry provides the best agreement with MSCT for aortic root dimensions before TAVI, though it still underestimates MSCT measurements.
Cite This Study
Ng et al. (2009) conducted an observational in Patients undergoing transcatheter aortic valve implantation (TAVI). 2D and 3D transesophageal echocardiography (TEE) vs. Multislice computed tomography (MSCT) was evaluated on Aortic annular and left ventricular outflow tract (LVOT) areas and geometries (p=<0.001). Two- and 3-dimensional TEE significantly underestimated MSCT planimetered aortic annular areas before TAVI (e.g., 3D TEE planimetered 4.22±0.77 vs MSCT 4.65±0.82 cm2, P<0.001).