title: Effect of body mass index on the image quality of rotational angiography without rapid pacing for planning of transcatheter aortic valve implantation: a comparison with multislice computed tomography.
abstract: OBJECTIVE
  To evaluate the feasibility of procedural planning for transcatheter aortic valve implantation (TAVI) using rotational angiography (R-angio) by comparison with multislice computed tomography (MSCT) and to investigate determinants of the image quality of R-angio.
  
  
  RESULTS
  Patients who underwent R-angio of the left ventricle and cardiac MSCT were eligible. R-angio acquisition was performed during contrast injection through a 6F pigtail catheter positioned in the left ventricle. On 3D R-angio and MSCT data sets, diameter measurements were made on short-axis images at the level of the aortic annulus (D(perimeter), D(area)), ascending aorta, sino-tubular junction (ST-junction), and the sinus of Valsalva. At the level of the aortic annulus, diagnostic image quality was obtained in 49 of 56 patients. In all patients with a body mass index (BMI) < 29 kg/m(2), image quality was acceptable whether or not rapid pacing was used. In patients with BMI ≥ 29 kg/m(2), the image quality was poor in 1 of 9 (11%) who were rapidly paced compared with 6 of 12 (50%) who were not. The correlation between R-angio and MSCT measurements was high for aortic annulus D(perimeter), D(area), ST-junction, Valsalva sinus, and ascending aorta (respectively, R = 0.90, 0.90, 0.91, 0.92, and 0.89). The correlations improved further when the analysis was limited to patients with a BMI < 29 kg/m(2) (respectively, 0.92, 0.92, 0.92, 0.92, and 0.93).
  
  
  CONCLUSIONS
  R-angio of the left ventricle allows precise measurement of the aortic root and annulus and was feasible for sizing at the time of TAVI. Diagnostic image quality was obtained without rapid pacing in all patients with a BMI < 29 kg/m(2).
authors.affiliation: Department of Cardiology, Erasmus MC, PB 412, Rotterdam 3000 CA, the Netherlands.
authors.forename: Carl J
authors.initials: CJ
authors.lastname: Schultz
authors.forename: Nicholas M
authors.initials: NM
authors.lastname: van Mieghem
authors.forename: Robert M
authors.initials: RM
authors.lastname: van der Boon
authors.forename: Anoeshka S
authors.initials: AS
authors.lastname: Dharampal
authors.forename: Guenter
authors.initials: G
authors.lastname: Lauritsch
authors.forename: Alexia
authors.initials: A
authors.lastname: Rossi
authors.forename: Adriaan
authors.initials: A
authors.lastname: Moelker
authors.forename: Gabriel
authors.initials: G
authors.lastname: Krestin
authors.forename: Robert
authors.initials: R
authors.lastname: van Geuns
authors.forename: Pim
authors.initials: P
authors.lastname: de Feijter
authors.forename: Patrick W
authors.initials: PW
authors.lastname: Serruys
authors.forename: Peter
authors.initials: P
authors.lastname: de Jaegere
mesh_terms: D000368:Aged; D000465:Algorithms; D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000601:surgery; D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging* / Q000601:surgery*; D015992:Body Mass Index; D003287:Contrast Media; D017023:Coronary Angiography / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D008297:Male; D018579:Patient Selection; D011474:Prosthesis Design; D017755:Prosthesis Fitting; D011829:Radiation Dosage; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome; D014283:Triiodobenzoic Acids
chemical_list: D003287:Contrast Media; D014283:Triiodobenzoic Acids; C044834:iodixanol
keywords: Annulus; Left ventricle; Multi-modality; Multislice computed tomography; Rotational angiography; Transcatheter aortic valve implantation