title: The use of MSCT for the evaluation of the aortic root before transcutaneous aortic valve implantation: the Rotterdam approach.
abstract: OBJECTIVE
  Whereas transthoracic echocardiography is the modality of choice for the diagnosis of severe aortic stenosis and cine-fluoroscopy is used to guide the implantation of the TAVI prosthesis, we believe that multislice computer tomography (MSCT) is the modality of choice for evaluation of the aortic root with a view to selecting patients with suitable anatomy and to guide sizing. We aim to describe an anatomical approach for the step by step interrogation of a 3D MSCT dataset to obtain the measurements of the aortic root required for patient selection, sizing and selection of the optimal angulation of the C-arm during the implantation procedure.
  
  
  RESULTS
  The landmarks used to anatomically define the aortic annulus and structures of the aortic root may be used to define the same structures for measurement on a 3D MSCT dataset by setting up orthogonal cut-planes including one axial to the aortic annulus. This allows true axial diameter measurements and also enables us to define the valve plane.
  
  
  CONCLUSIONS
  Measurement on the axial images avoids incorrect diameter measurements that do not pass through the central axis.
authors.affiliation: Department of Cardiology, Erasmus MC, Rotterdam, The Netherlands.
authors.forename: Carl
authors.initials: C
authors.lastname: Schultz
authors.forename: Adriaan
authors.initials: A
authors.lastname: Moelker
authors.forename: Apostolos
authors.initials: A
authors.lastname: Tzikas
authors.forename: Nicolo
authors.initials: N
authors.lastname: Piazza
authors.forename: Pim
authors.initials: P
authors.lastname: de Feyter
authors.forename: Robert J
authors.initials: RJ
authors.lastname: van Geuns
authors.forename: Patrick W
authors.initials: PW
authors.lastname: Serruys
authors.forename: Gabriel P
authors.initials: GP
authors.lastname: Krestin
authors.forename: Peter
authors.initials: P
authors.lastname: de Jaegere
mesh_terms: D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging / Q000601:surgery*; D004452:Echocardiography; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D014057:Tomography, X-Ray Computed / Q000379:methods*