title: Feasibility of a new method using two-dimensional transesophageal echocardiography for aortic annular sizing in patients undergoing transcatheter aortic valve implantation; a case-control study.
abstract: BACKGROUND
  Accurate preoperative assessment of the aortic annulus dimension is crucial for successful transcatheter aortic valve implantation (TAVI). In this study we validated a new method using two-dimensional transesophageal echocardiography (2D-TEE) for measurement of the aortic annulus prior to TAVI.
  
  
  METHODS
  We analysed 124 patients who underwent successful TAVI using a self-expandable prosthesis, divided equally into two groups; in the study group we used the cross sectional short axis 2D-TEE for measurement of the aortic annulus and in the control group we used the long axis 2D-TEE.
  
  
  RESULTS
  Both groups were comparable regarding the clinical parameters. On the other hand, patients in the study group had less left ventricular ejection fraction (38.9 % versus 45.6 %, p = 0.01). The aortic valve annulus was, although not statistically significant, smaller in the study group (21.58 versus 23.28 mm, p = 0.25). Post procedural quantification of the aortic regurgitation revealed that only one patient in both groups had severe aortic regurgitation (AR), in this patient the valve was implanted deep. The incidence of significant AR was higher in the control group (29.0 % versus 12.9 %, p = 0.027).
  
  
  CONCLUSIONS
  Sizing of the aortic valve annulus using cross-sectional 2D-TEE offers a safe and plausible method for patients undergoing TAVI using the self-expandable prosthesis and is significantly superior to using long axis 2D-TEE.
authors.affiliation: Cardiology Department, Wuerzburg University Clinic, Oberduerrbacher Street 6, 97080, Wuerzburg, Germany. mohammad_sherif@hotmail.com.
authors.forename: Mohammad A
authors.initials: MA
authors.lastname: Sherif
authors.affiliation: Cardiology Department, Magdeburg University Clinic, Magdeburg, Germany.
authors.forename: Joerg
authors.initials: J
authors.lastname: Herold
authors.affiliation: Cardiology Department, Wuerzburg University Clinic, Oberduerrbacher Street 6, 97080, Wuerzburg, Germany.
authors.forename: Wolfram
authors.initials: W
authors.lastname: Voelker
authors.affiliation: Cardiology Department, Wuerzburg University Clinic, Oberduerrbacher Street 6, 97080, Wuerzburg, Germany.
authors.forename: Octavian
authors.initials: O
authors.lastname: Maniuc
authors.affiliation: Cardiology Department, Wuerzburg University Clinic, Oberduerrbacher Street 6, 97080, Wuerzburg, Germany.
authors.forename: Georg
authors.initials: G
authors.lastname: Ertl
authors.affiliation: Cardiology Department, Magdeburg University Clinic, Magdeburg, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Praast
authors.affiliation: Cardiology Department, Magdeburg University Clinic, Magdeburg, Germany.
authors.forename: Ruediger Christian
authors.initials: RC
authors.lastname: Braun-Dullaeus
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000601:surgery; D001022:Aortic Valve Insufficiency / Q000000981:diagnostic imaging* / Q000601:surgery*; D016022:Case-Control Studies; D004452:Echocardiography / Q000379:methods*; D017548:Echocardiography, Transesophageal / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D065467:Transcatheter Aortic Valve Replacement / Q000379:methods*