Evaluation of a novel echocardiographic three-dimensional automated software for the assessment of the aortic root in candidates for transcatheter aortic valve replacement

Abstract

Objective To evaluate the accuracy of a novel echocardiographic three-dimensional automated software for the assessment of the aortic root in candidates for transcatheter aortic valve replacement(TAVR). Methods Four patterns(Lax, Lax-Res, Sax, Sax-Res) of 3D-TEE imaging of aortic root were gotten preoperatively in 18 patients with severe tricuspid aortic stenosis who were referred to our center for TAVR. The specialized 3D-TEE reconstruction software, eSie Valves, then automatically configured a geometric model of the aortic root from the images obtained by 3D-TEE and performed a quantitative analysis of these structures: the minimal diameter(Dmin), maximal diameter(Dmax), area and perimeter(Peri) of aortic annulus, height of the ostia of the left/right coronary artery above the aortic annulus(LOH/ROH). The echo dimensions were compared with the MDCT measurements. Results No statistically significant difference were found in above parameters between the ZOOM pattern (Sax-Res and Lax-Res) and CT measurements(all P>0.05). Lax-Res pattern measurements had good correlation with MDCT, with r valves of 0.81, 0.77, 0.89, 0.84 for Lax-Res-Dmin, Lax-Res-Dmax, Lax-Res-Area, Lax-Res-Peri, respectively(all P<0.05). 3D-TEE LOH/ROH had poor correlation with MDCT LOH/ROH (all r<0.7). Conclusions The new automatic 3D-TEE software allows modelling and quantifying the aortic annulus dimensions from 3D-TEE data in patients with tricuspid aortic valves, and Lax-Res pattern is recommended. Quantified assessment of LOH/ROH is not ideal and needs to be improved. Key words: Echocardiography, transesophageal; Transcatheter aortic valve replacement; Aortic valve stenosis