title: Annular sizing using real-time three-dimensional intracardiac echocardiography-guided trans-catheter aortic valve replacement.
abstract: Transcatheter aortic valve replacement (TAVR) has been established as an alternative therapy for patients with severe aortic stenosis who are unfit for the surgical aortic valve replacements. Pre and periprocedural imaging for the TAVR procedure is the key to procedural success. Currently transesophageal echocardiography (TOE), including real-time three-dimensional (RT-3D) imaging TOE, has been used for peri-interventional monitoring and guidance for TAVR. We describe our initial experience with real-time three-dimensional intracardiac echocardiography (RT-3DICE), imaging technology for the use in the TAVR procedure.
  
  
  
  We used RT-3DICE using an ACUSON SC2000 2.0v (Siemens Medical Solution), and a 10F AcuNav V catheter (Siemens-Acuson, Inc, Mountain View, California, USA) in addition to preoperative multislice CT (MSCT) in total of five patients undergoing TAVR procedure.
  
  
  
  Aortic annulus and sinus of valsalva diameters were measured using RT-3DICE. Aortic valve measurements obtained using RT-3DICE are comparable to those obtained using MSCT with no significant difference in our patients.
  
  
  
  This small study of five patients shows the safe use of RT-3DICE in TAVR Procedure and may help the procedures performed under local anaesthesia without the need for TOE.
authors.affiliation: Siemens UK ltd , London , UK.
authors.forename: Alejandro
authors.initials: A
authors.lastname: Rendon
authors.affiliation: Manchester Royal Infirmary, University of Central Manchester NHS foundation Trust , Manchester , UK.
authors.forename: Tahir
authors.initials: T
authors.lastname: Hamid
authors.affiliation: Royal Brompton Hospital , London , UK.
authors.forename: Gajen
authors.initials: G
authors.lastname: Kanaganayagam
authors.affiliation: Manchester Royal Infirmary, University of Central Manchester NHS foundation Trust , Manchester , UK.
authors.forename: Devinda
authors.initials: D
authors.lastname: Karunaratne
authors.affiliation: Manchester Royal Infirmary, University of Central Manchester NHS foundation Trust, Manchester, UK; University of California, San Francisco, USA.
authors.forename: Vaikom S
authors.initials: VS
authors.lastname: Mahadevan