title: Measurement of aortic valve annulus using different cardiac imaging techniques in transcatheter aortic valve implantation: agreement with finally implanted prosthesis size.
abstract: OBJECTIVE
  To compare the measurements of the aortic annulus obtained with various imaging techniques in patients with severe aortic stenosis scheduled for transcatheter aortic valve implantation, and to determine the grade of agreement between the predicted size of the prosthesis for each technique, and the size of the finally implanted valve.
  
  
  RESULTS
  The aortic annulus was measured in 40 patients treated by transcatheter aortic valve implantation (CoreValve aortic valve) with transthoracic (TTE) and transesophageal echocardiography (TEE), 64-slice tomography, and angiography. A large valve was implanted when annulus was >23 mm and a small one if it was ≤23 mm. If the size of the prosthesis predicted by several techniques was not the same in one case, we selected the size in which more techniques presented agreement. Forty aortic valves, 26 small and 14 large, were implanted percutaneously. The best correlation was obtained with TTE and TEE (r = 0.93, P < 0.001). The correlation of TTE and TEE with angiography also was good (r = 0.58, P < 0.001 and r = 0.53, P < 0.001, respectively). Correlations between these techniques and computed tomography were poor (P = NS for all comparisons). The best agreement between estimated aortic annulus and implanted valve size was obtained with transtoracic and TEE (κ= 0.88 and 0.76).
  
  
  CONCLUSIONS
  The aortic annulus measurements obtained by TTE, TEE, and angiography correlated well, while tomography correlated poorly with other techniques. The imaging techniques that showed the best agreement between estimated aortic annulus size and implanted aortic valve size were TTE and TEE.
authors.affiliation: Cardiology Department, Hospital Universitario Reina Sofía, Córdoba, Spain. dmesar@ya.com
authors.forename: Dolores
authors.initials: D
authors.lastname: Mesa Rubio
authors.forename: José
authors.initials: J
authors.lastname: Suárez de Lezo Cruz Conde
authors.forename: Manuel Pan
authors.initials: MP
authors.lastname: Alvarez-Osorio
authors.forename: Martin
authors.initials: M
authors.lastname: Ruiz Ortiz
authors.forename: Mónica
authors.initials: M
authors.lastname: Delgado Ortega
authors.forename: Maria del Carmen
authors.initials: Mdel C
authors.lastname: León del Pino
authors.forename: Francisco
authors.initials: F
authors.lastname: Toledano Delgado
authors.forename: Jose
authors.initials: J
authors.lastname: Segura Saint-Gerons
authors.forename: Soledad
authors.initials: S
authors.lastname: Ojeda Pineda
authors.forename: Daniel
authors.initials: D
authors.lastname: Garcia Fuertes
authors.forename: Manuel
authors.initials: M
authors.lastname: Crespín Crespín
authors.forename: Simona
authors.initials: S
authors.lastname: Espejo
authors.forename: Rusel
authors.initials: R
authors.lastname: Ysamat
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000000981:diagnostic imaging* / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging* / Q000601:surgery*; D017023:Coronary Angiography / Q000379:methods; D004452:Echocardiography / Q000379:methods; D005260:Female; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D011474:Prosthesis Design; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome