title: Comparison of accuracy of aortic root annulus assessment with cardiac magnetic resonance versus echocardiography and multidetector computed tomography in patients referred for transcatheter aortic valve implantation.
abstract: The evaluation of the aortic root in patients referred for transcatheter aortic valve implantation is crucial. The aim of the present study was to compare the accuracy of cardiac magnetic resonance (CMR) evaluation of the aortic annulus (AoA) with transthoracic and transesophageal echocardiography and multidetector computed tomography (MDCT) in patients referred for transcatheter aortic valve implantation. In 50 patients, maximum diameter, minimum diameter and AoA, length of the left coronary, right coronary, and noncoronary aortic leaflets, degree (grades 1 to 4) of aortic leaflet calcification, and distance between AoA and coronary artery ostia were assessed. AoA maximum diameter, minimum diameter, and area by CMR were 26.4 ± 2.8 mm, 20.6 ± 2.3 mm, 449.8 ± 86.2 mm(2), respectively. The length of left coronary, right coronary, and noncoronary leaflets by CMR were 13.9 ± 2.2, 13.3 ± 2.1, and 13.4 ± 1.8 mm, respectively, whereas the score of aortic leaflet calcifications was 2.9 ± 0.8. Finally, the distances between AoA and left main and right coronary artery ostia were 16.1 ± 2.8 and 16.1 ± 4.4 mm, respectively. Regarding AoA area, transthoracic and transesophageal echocardiography showed an underestimation (p <0.01), with a moderate agreement (r: 0.5 and 0.6, respectively, p <0.01) compared with CMR. No differences and excellent correlation were observed between CMR and MDCT for all parameters (r: 0.9, p <0.01), except for aortic leaflet calcifications that were underestimated by CMR. In conclusion, aortic root assessment with CMR including AoA size, aortic leaflet length, and coronary artery ostia height is accurate compared with MDCT. CMR may be a valid imaging alternative in patients unsuitable for MDCT.
authors.affiliation: Centro Cardiologico Monzino, IRCCS, Milan, Italy. Electronic address: gianluca.pontone@ccfm.it.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Pontone
authors.forename: Daniele
authors.initials: D
authors.lastname: Andreini
authors.forename: Antonio L
authors.initials: AL
authors.lastname: Bartorelli
authors.forename: Erika
authors.initials: E
authors.lastname: Bertella
authors.forename: Saima
authors.initials: S
authors.lastname: Mushtaq
authors.forename: Paola
authors.initials: P
authors.lastname: Gripari
authors.forename: Monica
authors.initials: M
authors.lastname: Loguercio
authors.forename: Sarah
authors.initials: S
authors.lastname: Cortinovis
authors.forename: Andrea
authors.initials: A
authors.lastname: Baggiano
authors.forename: Edoardo
authors.initials: E
authors.lastname: Conte
authors.forename: Virginia
authors.initials: V
authors.lastname: Beltrama
authors.forename: Andrea
authors.initials: A
authors.lastname: Annoni
authors.forename: Alberto
authors.initials: A
authors.lastname: Formenti
authors.forename: Gloria
authors.initials: G
authors.lastname: Tamborini
authors.forename: Manuela
authors.initials: M
authors.lastname: Muratori
authors.forename: Andrea
authors.initials: A
authors.lastname: Guaricci
authors.forename: Francesco
authors.initials: F
authors.lastname: Alamanni
authors.forename: Giovanni
authors.initials: G
authors.lastname: Ballerini
authors.forename: Mauro
authors.initials: M
authors.lastname: Pepi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001011:Aorta / Q000000981:diagnostic imaging / Q000473:pathology; D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000473:pathology; D001024:Aortic Valve Stenosis / Q000175:diagnosis* / Q000601:surgery; D001027:Aortography; D006328:Cardiac Catheterization; D057791:Cardiac Imaging Techniques / Q000379:methods*; D004452:Echocardiography; D005260:Female; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D061330:Multidetector Computed Tomography