Mitral Valve Annulus Dimensions Assessment with Three-Dimensional Echocardiography Versus Computed Tomography: Implications for Transcatheter Interventions.

Kensuke Hirasawa,Suzanne E Van Wijngaarden,Victoria Delgado,Stephan Milhorini Pio,Jeroen J Bax,Nina Ajmone Marsan,Tea Gegenava,N Mai Vo

doi:10.3390/jcm10040649

Kensuke Hirasawa, Suzanne E Van Wijngaarden + Show 6 more

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https://doi.org/10.3390/jcm10040649

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Abstract

The aim of this study is to evaluate the agreement between three-dimensional (3D) transesophageal echocardiography (TEE) and multidetector computed tomography (MDCT) for assessing mitral annular (MA) dimensions. A total of 105 patients (79 ± 9 years old, 52% male) who underwent clinically indicated 3D TEE and MDCT feasible for MA geometrical assessment were included. Using dedicated semi-automated postprocessing software, MA geometry, including mitral annular area (MAA), perimeter, septal-lateral (SL) diameter, and inter-trigonal (TT) diameter, was evaluated using 3D TEE and MDCT. Compared to 3D TEE, MAA, perimeter, and SL distance measured on MDCT data were larger (9.9 ± 3.0 vs. 9.3 ± 3.1 cm2 for MAA; 115 ± 18 vs. 108 ± 18 mm for perimeter; and 35 ± 5 vs. 32 ± 5 cm for SL distance, all p < 0.001). By contrast, the TT distance was comparable between MDCT and 3D TEE (26 ± 4 vs. 26 ± 4 cm, p = 0.258). The correlations of all the MA dimensions were good to excellent between the two modalities (R = 0.911 for MAA, 0.890 for perimeter, 0.739 for TT distance, and 0.857 for SL distance, respectively, all p < 0.001). This study showed good agreement between 3D TEE- and MDCT-derived MA measurements although MDCT systematically provided larger MAA, perimeter, and SL distance compared with 3D TEE.

Highlights

Accepted: 5 February 2021Based on the success of the transcatheter aortic valve implantation [1,2], transcatheter mitral valve (MV) implantation techniques have been developed [3,4]
While echocardiography is the mainstay imaging technique to assess the MV function, multidetector row computed tomography (MDCT) is the key imaging technique to assess the dimensions of the mitral valve annulus (MA) in patients who are candidates for transcatheter MV
The majority of the patients (n = 96, 91%) had severe aortic stenosis and underwent MDCT prior to transcatheter aortic valve implantation and 3D transesophageal echocardiographic (TEE) was performed during the procedure

Summary

Introduction

Based on the success of the transcatheter aortic valve implantation [1,2], transcatheter mitral valve (MV) implantation techniques have been developed [3,4]. While echocardiography is the mainstay imaging technique to assess the MV function, multidetector row computed tomography (MDCT) is the key imaging technique to assess the dimensions of the MA in patients who are candidates for transcatheter MV implantation [6,7]. Comparison between semi-automated software to assess the MA dimensions and geometry based on 3D transesophageal echocardiographic (TEE). We aimed to evaluate the agreement between these two imaging modalities for assessing MA geometry using specific semi-automated software

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