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- Title
Odabir pacijenata za implantaciju TAVI - optimalno mjerenje anulusa aortne valvule.
- Authors
Lukšić, Vlatka Rešković; Maček, Jana Ljubas; Ostojić, Zvonimir; Večerić, Sandra; Ceković, Sanja; Konja, Blanka Glavaš; Benčić, Martina Lovrić; Bulum, Joško; Hanževački, Jadranka Šeparović
- Abstract
Background. In selection patients for transcatheter aortic valve implantation (TAVI), one of the most important measurements is aortic annulus dimension for optimal valve type selection and sizing, being crucial for the procedure success.1 The aim of the study is to validate different echocardiography tools versus CT for aortic annulus measurement. Methods and Results. 24 consecutive patients who underwent successful CoreValve implantation in University Hospital Center Zagreb were enrolled. Selection of valve dimension was based on CT measurements of aortic annulus (mean diameter and perimeter). All patients underwent transthoracic echocardiography (TTE) prior procedure. 2D transesophageal (TOE) echo was performed in all but one patient (due to contraindications), and 3D TOE in 13 pts. Data was analyzed retrospectively, investigator being blinded for the implanted valve size. Annulus diameter was measured from 2D TTE parasternal view, 2D TOE (120°) and 3D multiplane views. 3D TOE perimeter derived annulus diameter was also obtained. 4 CT examinations were incongruent with the implanted valve size. Compared to CT measurements, only 9/24 (37.5%) pts were correctly measured by 2D TTE and 15 pts (62.5%) were undersized. For 2D TOE compared to CT, 11/23 (47.8%) measurements were correct, 10 (43.5%) undersized and 2 (8.7%) oversized. 3D TOE compared to CT was correct in 10/13 (76.9%) pts, 1 (7.7%) being undersized, and 2 (15.4%) oversized. The majority of patients were implanted CoreValve size 26 (13 pts) and 29 (7 pts) - multimodality measurements are shown in Table 1. 2D TTE and TOE underestimate annulus size compared to CT for 1-3mm. 3D TOE measurements differ from CT for <0.5mm. Conclusion. CT, as well as 3D TOE have been shown to provide more accurate aortic annulus geometric measurements. Unlike 2D TTE and TOE they, especially combined, can estimate correct valve size and overstep pitfalls, even when aortic annulus is oval shaped, irregular or severely calcified.
- Publication
Cardiologia Croatica, 2016, Vol 11, Issue 10/11, p485
- ISSN
1848-543X
- Publication type
Article
- DOI
10.15836/ccar2016.485