Accuracy of Aortic Annulus Diameter Measurement: Comparison of Multi-Detector CT, Two- and Three-Dimensional Echocardiography.

Abstract

Accurate preprocedural quantification of the aortic annulus diameter is crucial for the operative success of the aortic valve surgery and especially transcatheter aortic valve replacement (TAVR). We conducted a prospective study to compare the accuracy of preoperative aortic annulus measurements using different imaging methods and direct measurements for aortic valve surgery. We enrolled 52 patients who underwent open aortic valve surgery between March 2012 and March 2014. Aortic annulus diameter was prospectively measured by transthoracic two-dimensional echocardiography (2D-TTE), transesophageal three-dimensional echocardiography (3D-TEE), and multi-detector computed tomography (MDCT). Imaging measurements were performed blindly by lab technicians. At surgery, the aortic annulus diameter was directly measured. Of the three methods, MDCT provided the smallest error in determining aortic annulus size as compared with the measurements at surgery. The limit of agreement of the aortic diameter by MDCT was smallest in the present study. The MDCT provided the most accurate measurement of aortic annulus diameter compared with 2D-TTE and 3D-TEE.