title: Accuracy of intracardiac echocardiography for aortic root assessment in patients undergoing transcatheter aortic valve implantation.
abstract: BACKGROUND
  Multislice computed tomography (MSCT) has generally been accepted as the most accurate modality fulfilling this purpose with good reproducibility. A major drawback of MSCT consists in the use of contrast dye, which may be unsafe in transcatheter aortic valve implantation (TAVI) patients who frequently are affected by renal failure. We sought to appraise the accuracy of intracardiac echocardiography (ICE) in measurements of structures in the aortic root in patients undergoing TAVI.
  
  
  METHODS
  Aortic annulus and sinus of Valsalva diameters were measured using ICE, performed during standard invasive preprocedural assessment in 30 consecutive patients with severe aortic stenosis referred for TAVI. Multislice computed tomography was performed in all patients afterward, and aortic root measurements were made by an independent radiologist.
  
  
  RESULTS
  Effective ICE measurements were obtained in all patients, easily and without any complication. Mean aortic annulus diameters were 21.9 ± 1.8 mm using ICE, 22.0 ± 1.9 mm using MSCT (3-chamber [3-C] view) and 22.8 ± 1.8 mm using the mean of long-axis and short-axis (L-ax/S-ax) view MSCT (P = .192, ICE vs 3-C MSCT; P < .001, ICE vs L-ax/S-ax MSCT, respectively). Correlation between ICE and both MSCT measurements was good (r(2) = 0.83, P < .001; r(2) = 0.80, P < .001, respectively). Mean sinus of Valsalva diameters were 32.3 ± 3.3 mm using ICE and 32.5 ± 3.1 mm using 3-C MSCT view (P = .141). Even in this case, correlation between ICE and both MSCT measurements was excellent (r(2) = 0.96, P < .001).
  
  
  CONCLUSIONS
  In patients referred for TAVI, measurements of the aortic annulus and the sinus of Valsalva using ICE compare favorably with those made at MSCT. This approach might be a useful and reproducible strategy in patients with severe renal impairment to avoid the administration of contrast dye during MSCT.
authors.affiliation: Division of Cardiology Ferrarotto Hospital, Catania, Italy.
authors.forename: Gian Paolo
authors.initials: GP
authors.lastname: Ussia
authors.forename: Marco
authors.initials: M
authors.lastname: Barbanti
authors.forename: Kunal
authors.initials: K
authors.lastname: Sarkar
authors.forename: Miriam
authors.initials: M
authors.lastname: Cumbo
authors.forename: Patrizia
authors.initials: P
authors.lastname: Aruta
authors.forename: Marilena
authors.initials: M
authors.lastname: Scarabelli
authors.forename: Valeria
authors.initials: V
authors.lastname: Cammalleri
authors.forename: Sebastiano
authors.initials: S
authors.lastname: Immè
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Pistritto
authors.forename: Simona
authors.initials: S
authors.lastname: Gulino
authors.forename: Wanda
authors.initials: W
authors.lastname: Deste
authors.forename: Gaetano
authors.initials: G
authors.lastname: Zingali
authors.forename: Valeria
authors.initials: V
authors.lastname: Garretto
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Mulè
authors.forename: Salvatore
authors.initials: S
authors.lastname: Scandura
authors.forename: Corrado
authors.initials: C
authors.lastname: Tamburino
mesh_terms: D000328:Adult; D001021:Aortic Valve / Q000000981:diagnostic imaging*; D001024:Aortic Valve Stenosis / Q000601:surgery*; D004452:Echocardiography / Q000379:methods; D005260:Female; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008297:Male; D061330:Multidetector Computed Tomography; D011446:Prospective Studies; D015203:Reproducibility of Results; D012850:Sinus of Valsalva / Q000000981:diagnostic imaging*; D018084:Ultrasonography, Interventional