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Accuracy of three-dimensional echocardiography in candidates for transcatheter aortic valve replacement
- Source :
- The International Journal of Cardiovascular Imaging. 36:291-298
- Publication Year :
- 2019
- Publisher :
- Springer Science and Business Media LLC, 2019.
-
Abstract
- The correct determination of aortic annulus dimensions is a crucial step to avoid complications in Transcatheter Aortic Valve Replacement (TAVR). Currently, the gold standard method for the evaluation of the aortic annulus is Multidetector Computed Tomography (MDCT), which is limited by the risk of contrast-induced nephropathy. Three-dimensional transesophageal echocardiography automated software (3DTEEa) have been used as an alternative in patients with contra-indications to MDCT. We aimed to evaluate the accuracy of 3DTEEa-derived aortic annulus dimensions; to assess the influence of calcification in the agreement between 3DTEEa and MDCT; and to determine reclassification in prosthesis size choice if 3DTEEa was the only imaging method. One hundred and seven consecutive patients referred for TAVR were studied. Aortic annulus dimensions were determined using MDCT and 3DTEE manual (3DTEEm) and automated measurements. Valve calcification was assessed with MDCT. Limits of agreement (LOA) were narrower for 3DTEEa (minimum diameter: mean bias 0.60; LOA - 2.94 to 4.14; maximum diameter: mean bias 0.20; LOA - 3.82 to 4.22) as compared to 3DTEEm (minimum diameter: mean bias 0.22; LOA - 3.84 to 4.28; maximum diameter: mean bias - 1.25; LOA - 6.37; 3.86). Compared to MDCT, 3DTEEa overestimated while 3DTEEm underestimated most parameters. No differences were found in average bias between methods according to quartiles of valve calcification. Most patients would have received the same size valve (63.9%) if 3DTEEa was the only available method. Measurement of aortic annulus dimensions using a 3DTEE automatic software is feasible and not influenced by valve calcification. It may be an alternative for patients who cannot undergo MDCT.
- Subjects :
- Male
medicine.medical_treatment
Clinical Decision-Making
Echocardiography, Three-Dimensional
030204 cardiovascular system & hematology
Prosthesis Design
Prosthesis
Transcatheter Aortic Valve Replacement
03 medical and health sciences
0302 clinical medicine
Valve replacement
Predictive Value of Tests
Image Interpretation, Computer-Assisted
Multidetector Computed Tomography
medicine
Humans
Radiology, Nuclear Medicine and imaging
Prospective Studies
cardiovascular diseases
030212 general & internal medicine
Cardiac skeleton
Cardiac imaging
Aged
Aged, 80 and over
business.industry
Patient Selection
Calcinosis
Reproducibility of Results
Aortic Valve Stenosis
Gold standard (test)
medicine.disease
Quartile
Aortic Valve
Heart Valve Prosthesis
Aortic valve stenosis
cardiovascular system
Feasibility Studies
Female
Cardiology and Cardiovascular Medicine
business
Nuclear medicine
Echocardiography, Transesophageal
Calcification
Subjects
Details
- ISSN :
- 15730743 and 15695794
- Volume :
- 36
- Database :
- OpenAIRE
- Journal :
- The International Journal of Cardiovascular Imaging
- Accession number :
- edsair.doi.dedup.....25ee7bf1a61b5b9667a415af55fe4e0c