Interobserver agreement in selecting TPVR devices using 3D anatomies was fair to moderate in adults and slight to fair in pediatric cases, with perfect agreement in only 8 of 60 cases.
Observational (n=60)
Yes
What is the interobserver agreement among experienced observers in selecting transcatheter pulmonary valve devices using 3D patient-specific anatomies?
There is limited interobserver agreement in selecting transcatheter pulmonary valve devices, particularly in pediatric anatomies, underscoring the variability in procedural planning and device preference.
ABSTRACT Background Transcatheter pulmonary valve replacement (TPVR) requires selecting the optimal device type, size, and position. Variability in anatomical shape may affect procedural planning. Aim This study aimed to evaluate interobserver agreement (IOA) in TPVR device selection using 3D patient‐specific anatomies and explore a framework for determining agreement. Methods Six experienced observers from three regions of the Americas independently assessed valve type (self‐expanding S‐E, balloon‐expandable B‐E, surgical approach SA), size, and position for 60 3D reconstructed anatomies (pediatric and adult) derived from cardiac magnetic resonance images. Agreement was quantified using Cohen's and Fleiss' Kappa coefficients. Results and Discussion Overall, IOA was fair to moderate in the adult group and slight to fair in the pediatric group. Perfect agreement occurred in only eight cases, seven involving S‐E valves and one SA. S‐E valves were generally selected for anatomies with regular geometry but variable curvature, while SA valves were mainly chosen for markedly large or small anatomies. B‐E selections showed no consistent pattern. One consideration of this study is that not all transcatheter therapies were available across the regions, which may have influenced decision‐making. Additionally, interventionists typically rely on 2D imaging for procedural planning, and the use of 3D reconstructions without clinical data may also have influenced the results. Coronary anatomy was not included in the assessment. Conclusion Agreement in selecting TPVR devices is limited for the pediatric group but moderate for adults. Variation in preferences among observers highlights the need for equitable access to diverse valve solutions across different RVOT‐PA anatomies and demographic contexts.
Pérez-Cualtán et al. (Wed,) conducted a observational in Transcatheter pulmonary valve replacement (n=60). TPVR device selection using 3D patient-specific anatomies was evaluated on Interobserver agreement in TPVR device selection. Interobserver agreement in selecting TPVR devices using 3D anatomies was fair to moderate in adults and slight to fair in pediatric cases, with perfect agreement in only 8 of 60 cases.