OC02 AUTOMATIC 3D-ECHO AORTIC ANNULUS MEASUREMENT FOR A PRECISE PREOPERATIVE TAVI PLANNING: IS IT ALREADY FEASIBLE?

Abstract

Background and aim: Transcatheter aortic valve implantation is a wide-spreading technique. The advent of recent softwares based on 3D transoesophageal echo is updating the role of ultrasound in the preoperative prosthesis sizing because of its potentiality to provide precise measurements of the aortic annulus avoiding X-ray and contrast material. Aim of this study is to verify the reliability of echo measurements. Methods: We enrolled 15 patients with severe aortic stenosis and 5 with healthy aortic valve. All patients underwent ECG-gated angio CT-scan and 3D transoesophageal echocardiogram. We blindly compared the two sets of data focusing on annulus and sinuses dimensions. Results: Statistically significant differences were found in aortic annulus diastolic maximum diameter and perimeter. Although not significant, the small differences highlighted in systole would have led to the choice of a different prosthesis size in 33% of the patients in case of CoreValve Evolut R, in 40% in case of Sapien 3 and in 60% in case of Lotus valve. Conclusions: Although not significant, the small differences between echo and CT measurements, if at the extremities of different size range, lead to a different transcatheter prosthesis size choice with potential relevant clinical effect.