Multimodal Assessment of the Aortic Annulus DiameterImplications for Transcatheter Aortic Valve Implantation
David Messika-Zeitoun, MD, PhD*, ,*,
Jean-Michel Serfaty, MD, PhD ,
Eric Brochet, MD,
Gregory Ducrocq, MD,
Laurent Lepage, MD,
Delphine Detaint, MD,
Fabien Hyafil, MD,
Dominique Himbert, MD,
Nicoletta Pasi, MD,
Jean-Pierre Laissy, MD, PhD,
Bernard Iung, MD and
Alec Vahanian, MD
* INSERM, U698, University Paris 7, Paris, France
Department of Radiology, AP-HP, Bichat Hospital, Paris, France
Department of Cardiology, AP-HP, Bichat Hospital, Paris, France
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Figure 1 Echocardiographic Measurements of the Aortic Annulus Diameter
Examples of measurements of the annulus diameter by (A) transthoracic echocardiography and (B) transesophageal echocardiography.
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Figure 2 Three-Dimensional Reconstruction and Measurement of the Aortic Annulus Diameter Using Multislice Computed Tomography
(A) Aortic root with the 3-dimensional reconstruction of the aortic annulus showing its crown-like shape. (B) Short-axis view of the ascending aorta at the Valsalva level. (C) Short-axis view of the aortic root at the level of the basal attachment of the aortic leaflet. The red arrows show the long- and short-axis diameters measured at the level of this virtual basal ring. (D) Measurements of the aortic annulus in the 3-chamber view (plane similar to echocardiographic long-axis plane). The small white arrows represent the hinge point of the leaflet into the aortic wall.
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Figure 3 Correlations Between Echocardiographic Measurements of the Aortic Annulus Diameter
(A) Correlation between the annulus diameter measured by transthoracic echocardiography (TTE) and by transesophageal echocardiography (TEE). The solid line indicates the regression line. (B) Quality control plots using Bland-Altman analysis for the 2 methods. The middle line represents the mean, the upper line represents +2 SDs, and the lower line represents –2 SDs.
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Figure 4 Correlations Between Echocardiographic and MSCT Measurements of the Aortic Annulus Diameter
Correlations between the aortic annulus measured by multislice computed tomography (MSCT) using the 3-chamber view and (A) TTE and (B) TEE. The solid line indicates the regression line. Quality control plots using Bland-Altman analysis for the 2 methods, (C) TTE and (D) TEE. The middle line represents the mean, the upper line represents +2 SDs, and the lower line represents –2 SDs. Abbreviations as in Figure 3.
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