title: Accuracy and reproducibility of novel echocardiographic three-dimensional automated software for the assessment of the aortic root in candidates for thanscatheter aortic valve replacement.
abstract: OBJECTIVE
  A specialized three-dimensional transoesophageal echocardiography (3D-TOE) reconstruction tool has recently been introduced; the system automatically configures a geometric model of the aortic root from the images obtained by 3D-TOE and performs quantitative analysis of these structures. The aim of this study was to compare the measurements of the aortic annulus (AA) obtained by the new model to that obtained by 3D-TOE and multidetector computed tomography (MDCT) in candidates to transcatheter aortic valve implantation (TAVI) and to assess the reproducibility of this new method.
  
  
  RESULTS
  We included 31 patients who underwent TAVI. The AA diameters and area were evaluated by the manual 3D-TOE method and by the automatic software. We showed an excellent correlation between the measurements obtained by both methods: intra-class correlation coefficient (ICC): 0.731 (0.508-0.862), r: 0.742 for AA diameter and ICC: 0.723 (0.662-0.923), r: 0.723 for the AA area, with no significant differences regardless of the method used. The interobserver variability was superior for the automatic measurements than for the manual ones. In a subgroup of 10 patients, we also found an excellent correlation between the automatic measurements and those obtained by MDCT, ICC: 0.941 (0.761-0.985), r: 0.901 for AA diameter and ICC: 0.853 (0.409-0.964), r: 0.744 for the AA area.
  
  
  CONCLUSIONS
  The new automatic 3D-TOE software allows modelling and quantifying the aortic root from 3D-TOE data with high reproducibility. There is good correlation between the automated measurements and other 3D validated techniques. Our results support its use in clinical practice as an alternative to MDCT previous to TAVI.
authors: Department of Cardiology, Ramón y Cajal University Hospital, Ctra. Colmenar, km 9,100, Madrid 28034, Spain aggarciamartin@gmail.com.
authors: Ana
authors: A
authors: García-Martín
authors: Department of Cardiology, Ramón y Cajal University Hospital, Ctra. Colmenar, km 9,100, Madrid 28034, Spain.
authors: Carla
authors: C
authors: Lázaro-Rivera
authors: Department of Cardiology, Ramón y Cajal University Hospital, Ctra. Colmenar, km 9,100, Madrid 28034, Spain.
authors: Covadonga
authors: C
authors: Fernández-Golfín
authors: Department of Cardiology, Ramón y Cajal University Hospital, Ctra. Colmenar, km 9,100, Madrid 28034, Spain.
authors: Luisa
authors: L
authors: Salido-Tahoces
authors: Department of Cardiology, Ramón y Cajal University Hospital, Ctra. Colmenar, km 9,100, Madrid 28034, Spain.
authors: Jose-Luis
authors: JL
authors: Moya-Mur
authors: Department of Cardiology, Ramón y Cajal University Hospital, Ctra. Colmenar, km 9,100, Madrid 28034, Spain.
authors: Jose-Julio
authors: JJ
authors: Jiménez-Nacher
authors: Department of Cardiology, Ramón y Cajal University Hospital, Ctra. Colmenar, km 9,100, Madrid 28034, Spain.
authors: Eduardo
authors: E
authors: Casas-Rojo
authors: Department of Cardiology, Ramón y Cajal University Hospital, Ctra. Colmenar, km 9,100, Madrid 28034, Spain.
authors: Iolanda
authors: I
authors: Aquila
authors: Department of Cardiology, Ramón y Cajal University Hospital, Ctra. Colmenar, km 9,100, Madrid 28034, Spain.
authors: Ariana
authors: A
authors: González-Gómez
authors: Department of Cardiology, Ramón y Cajal University Hospital, Ctra. Colmenar, km 9,100, Madrid 28034, Spain.
authors: Rosana
authors: R
authors: Hernández-Antolín
authors: Department of Cardiology, Ramón y Cajal University Hospital, Ctra. Colmenar, km 9,100, Madrid 28034, Spain.
authors: José Luis
authors: JL
authors: Zamorano
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001011:Aorta / Q000000981:diagnostic imaging; D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging* / Q000401:mortality / Q000601:surgery*; D001331:Automation; D015331:Cohort Studies; D019560:Echocardiography, Three-Dimensional / Q000295:instrumentation / Q000379:methods*; D017548:Echocardiography, Transesophageal; D005260:Female; D006801:Humans; D008297:Male; D061330:Multidetector Computed Tomography / Q000379:methods*; D015588:Observer Variation; D018579:Patient Selection; D011300:Preoperative Care / Q000379:methods; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012984:Software; D065467:Transcatheter Aortic Valve Replacement / Q000379:methods*; D016896:Treatment Outcome
keywords: 3D echocardiography; aortic valve; transcatheter aortic valve implantation