Document Detail


Aortic annulus evaluation in transcatheter aortic valve implantation.
MedLine Citation:
PMID:  20518012     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
OBJECTIVES: We compared the annulus diameters measured by transthoracic echocardiography (TTE), transesophageal echocardiography (TEE), and dual-source computed tomography (DSCT) before transcatheter aortic valve implantation (TAVI).
BACKGROUND: In TAVI correct evaluation of the aortic annulus is mandatory to choose the correct prosthesis type and size and to prevent complications. There is no gold standard for the assessment of aortic annulus diameters.
METHODS: Preoperative assessment of the aortic annulus with TTE, TEE, and DSCT was performed in 187 consecutive patients referred for TAVI between June 2007 and May 2009.
RESULTS: The mean aortic annuli were 22.6 ± 2.0 mm measured with DSCT, 22.3 ± 2.5 mm with TTE, and 22.9 ± 2.2 mm with TEE. Despite a strong correlation between the measurement techniques, relevant statistical spread occurred with differences up to 3 mm in all measurement methods. Inter- and intraobserver variability was good for TEE and less satisfactory for DSCT measurements. TEE measurements taken as decisive parameter for the implantation changed the implantation strategy in 15.5% of patients and did not show an increased rate of procedural complications.
CONCLUSION: Despite a strong correlation, the measurement techniques for the aortic annulus show relevant statistical spread, consequently one measurement technique cannot definitely predict another. TEE measurements show a more satisfactory intra- and interobserver variability than DSCT. Taking TEE annulus measurements as decisive parameter for the implantation has an impact on the implantation strategy and is safe with a low rate of procedural complications.
Authors:
Andrea Hutter; Anke Opitz; Sabine Bleiziffer; Hendrik Ruge; Ina Hettich; Domenico Mazzitelli; Albrecht Will; Peter Tassani; Robert Bauernschmitt; Ruediger Lange
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions     Volume:  76     ISSN:  1522-726X     ISO Abbreviation:  Catheter Cardiovasc Interv     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-11-25     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100884139     Medline TA:  Catheter Cardiovasc Interv     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1009-19     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 Wiley-Liss, Inc.
Affiliation:
Clinic for Cardiovascular Surgery, German Heart Centre Munich, Munich, Germany. huttera@dhm.mhn.de
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Comment In:
Catheter Cardiovasc Interv. 2010 Dec 1;76(7):1020-1   [PMID:  21108377 ]

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