Key result
Multidetector computed tomography provided the most accurate prediction of aortic annulus diameter (23.9 mm) compared to surgical measurement (23.7 mm, p=0.2248), whereas echocardiography significantly underestimated the size.
Why the study?
Does multidetector computed tomography provide the best agreement with surgical measurement for aortic annulus diameter compared to transthoracic echocardiography and contrast angiography in patients undergoing aortic valve replacement?
Observational (n=55)
No
Does multidetector computed tomography provide the best agreement with surgical measurement for aortic annulus diameter compared to transthoracic echocardiography and contrast angiography in patients undergoing aortic valve replacement?
Absolute Event Rate: 23.9% vs 23.7%
p-value: p=0.2248
Multidetector computed tomography is the most accurate non-invasive imaging modality for measuring aortic annulus diameter compared to surgical sizing.
MDCT may most accurately estimate aortic annulus diameter; leaves open whether it improves AVR outcomes versus echo in prospective studies.
PURPOSE: The purpose of this study was to clarify the most suitable method to measure the aortic annulus diameter. PATIENTS AND METHODS: Fifty-five patients, who had undergone aortic valve replacement at Miyazaki University Hospital between April 2008 and May 2011, were included in this study. The maximum diameter of the sizing tool that could be inserted into the left ventricle through the annulus had been predicted, based on the diameter measured by each modality. Agreement with surgery and each imaging modality, namely transthoracic echocardiography, multidetector computed tomography and contrast angiography, were compared using Bland-Altman analysis. RESULTS: The predicted aortic annulus diameter, based on the diameter measured by transthoracic echocardiography, multidetector computed tomography and contrast angiography, was 20.3 ± 2.50, 23.9 ± 3.19, and 23.5 ± 3.55 mm, respectively, whereas, the diameter measured at surgery was 23.7 ± 2.99 mm. Predicted aortic annulus diameter measured by multidetector computed tomography best agreed with that measured at surgery. CONCLUSION: We conclude that the aortic annulus diameter, measured by multidetector computed tomography, is the best modality to measure the aortic annulus diameter.
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Yano et al. (2012) conducted an observational in Aortic valve replacement (n=55). Multidetector computed tomography (MDCT) vs. Surgical measurement was evaluated on Predicted aortic annulus diameter (mm) (p=0.2248). Multidetector computed tomography provided the most accurate prediction of aortic annulus diameter (23.9 mm) compared to surgical measurement (23.7 mm, p=0.2248), whereas echocardiography significantly underestimated the size.
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