title: Aortic root geometry in aortic stenosis patients (a SEAS substudy).
abstract: OBJECTIVE
  To report aortic root geometry by echocardiography in a large population of healthy, asymptomatic aortic stenosis (AS) patients in relation to current vendor-specified requirements for transcatheter aortic valve implantation (TAVI).
  
  
  RESULTS
  Baseline data in 1481 patients with asymptomatic AS (mean age 67 years, 39% women) in the Simvastatin Ezetimibe in AS study were used. The inner aortic diameter was measured at four levels: annulus, sinus of Valsalva, sinotubular junction and supracoronary, and sinus height as the annulo-junctional distance. Analyses were based on vendor-specified requirements for the aortic root geometry for current available prostheses, CoreValve and Edwards-Sapien. The ratio of sinus of Valsalva height to sinus width was 1:2. In multivariate linear regression analysis, larger sinus of Valsalva height was associated with older age, larger sinus of Valsalva diameter, lower ejection fraction and smaller supracoronary diameter (multiple R(2) = 0.19, P< 0.01). The required annulus diameter for implantation of CoreValve was met in 61.9%, and for the Edwards-Sapien prosthesis in 66.9%. Overall, annular dimension feasible for TAVI using any available prosthesis was found in 78.2% of patients and in 77.7% of patients also the required minimum sinus of Valsalva height was found. Comparing the group of patients who met TAVI requirements to those who did not, the latter included more women and patients with lower body height and weight and significantly smaller aortic root diameters (all P < 0.05).
  
  
  CONCLUSIONS
  Among AS patients in the SEAS study, 27% of women and 19% of men did not have aortic root geometry fulfilling current requirements for TAVI.
authors.affiliation: Asklepios Clinic St. Georg, Department of Cardiology, Hamburg, Germany. doc_edda@hotmail.com
authors.forename: Edda
authors.initials: E
authors.lastname: Bahlmann
authors.forename: Christoph A
authors.initials: CA
authors.lastname: Nienaber
authors.forename: Dana
authors.initials: D
authors.lastname: Cramariuc
authors.forename: Christa
authors.initials: C
authors.lastname: Gohlke-Baerwolf
authors.forename: Simon
authors.initials: S
authors.lastname: Ray
authors.forename: Richard B
authors.initials: RB
authors.lastname: Devereux
authors.forename: Kristian
authors.initials: K
authors.lastname: Wachtell
authors.forename: Karl Heinz
authors.initials: KH
authors.lastname: Kuck
authors.forename: Einar
authors.initials: E
authors.lastname: Davidsen
authors.forename: Eva
authors.initials: E
authors.lastname: Gerdts
mesh_terms: D000368:Aged; D001011:Aorta / Q000033:anatomy & histology / Q000000981:diagnostic imaging / Q000473:pathology*; D001021:Aortic Valve / Q000033:anatomy & histology / Q000000981:diagnostic imaging / Q000473:pathology*; D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging / Q000473:pathology* / Q000628:therapy; D005240:Feasibility Studies; D005260:Female; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D016014:Linear Models; D008297:Male; D015999:Multivariate Analysis; D011446:Prospective Studies; D012720:Severity of Illness Index; D012850:Sinus of Valsalva / Q000033:anatomy & histology / Q000000981:diagnostic imaging / Q000473:pathology*; D013223:Statistics as Topic; D014463:Ultrasonography