Abstract 13621: Prospective Study to Evaluate the Accuracy of Aortic Annulus Diameter Measurement: a Comparison of Multi-detector CT versus Two- and Three- Dimensional Echocardiography
OBJECTIVE: Accurate preoperative quantification of the aortic annulus diameter is crucial for the success of aortic valve surgery, especially transcatheter aortic valve implantation (TAVI). We conducted this prospective study to compare the accuracy of preoperative aortic annulus measurement to direct measurements taken during open aortic valve surgery.
METHODS: We enrolled 52 patients who underwent open aortic valve surgery between February 2012 and October 2013. In each case, we used transthoracic two-dimensional echocardiography (2D-TTE), transesophageal three-dimensional echocardiography (3D-TEE), and multi-detector CT (MDCT) to measure the diameter of the aortic annulus. Lab technicians performed the measurements blindly, and then the diameter of the aortic annulus was measured directly at surgery. The results of these intraoperative aortic annulus measurements were not revealed until the study ended in October 2013.
RESULTS: The results of all three methods presented certain measures of accuracy; however,, none was perfect. Of the three methods, MDCT provided the smallest margin of error when compared to direct measurements taken at surgery. MDCT provided the smallest (95%) probability range (within±1.96SD) for measuring the aortic diameter of all the imaging methods used in this present study. However, the diameter predicted by MDCT was slightly larger (by about 1 mm) than the direct measures taken during surgery.(Figure)
CONCLUSIONS: MDCT measurements provided the closest agreement in measuring the diameter of the aortic annulus compared to 2D-TTE and 3D-TEE; however, there was fixed positive bias of about 1mm. We may be able to eliminate this bias as we obtain more data from MDCT and compensate accordingly.
Author Disclosures: H. Tsuneyoshi: None. T. Komiya: None. T. Shimamoto: None.
- © 2014 by American Heart Association, Inc.