Comparison of aortic root measurements in patients undergoing transapical aortic valve implantation (TA-AVI) using three-dimensional rotational angiography (3D-RA) and multislice computed tomography (MSCT): differences and variability

  • Lukas H. J. Lehmkuhl
  • Konstantin von Aspern
  • Borek Foldyna
  • Matthias Grothoff
  • Stefan Nitzsche
  • Joerg Kempfert
  • Ardawan Rastan
  • Axel Linke
  • Friedrich W. Mohr
  • Alois Noettling
  • Thomas Walther
  • Matthias Gutberlet
Original Paper

Abstract

To evaluate for the first time the degree of compliance between conventional multislice computed tomography (MSCT) and three-dimensional rotational angiography (3D-RA) in measuring relevant dimensions of the aortic annulus, the aortic root and the thoracic aorta in patients undergoing TA-AVI. Twenty-seven patients (82 ± 11 years) with severe aortic stenosis received contrast enhanced ECG gated MSCT prior to TA-AVI and intra-procedural rotational angiography. The aortic annulus size, the distance to the coronary ostia and diameters of the aortic root and the thoracic aorta were measured with both methods by two observers blinded to each other. Linear regression and Bland–Altman analysis were performed to determine the degree of compliance between both methods. The limits of agreement were within two standard deviations for all measurements and with high correlation especially for the supra-annular dimensions. Sizing of the aortic annulus revealed lower interobserver variability for MSCT than for 3D-RA with a maximum deviation of 2.1 ± 2.5 and 1.7 ± 2.8 mm for diameter measurements and for the effective diameter, respectively. With current protocols intra-procedural 3D-RA provides good image quality especially for structures above the aortic annulus. Due to a lower interobserver variability in sizing the aortic annulus MSCT remains more suitable for aortic root assessment prior to TA-AVI.

Keywords

Computed tomography Rotational angiography C-arm-CT Aortic valve Percutaneous valve implantation 

Notes

Acknowledgments

The co-author Alois Noettling is employee of Siemens AG, Healthcare Sector, Forchheim, Germany

Conflict of interest

None declared.

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Copyright information

© Springer Science+Business Media, B.V. 2012

Authors and Affiliations

  • Lukas H. J. Lehmkuhl
    • 1
  • Konstantin von Aspern
    • 1
  • Borek Foldyna
    • 1
  • Matthias Grothoff
    • 1
  • Stefan Nitzsche
    • 1
  • Joerg Kempfert
    • 5
  • Ardawan Rastan
    • 2
  • Axel Linke
    • 4
  • Friedrich W. Mohr
    • 2
  • Alois Noettling
    • 3
  • Thomas Walther
    • 5
  • Matthias Gutberlet
    • 1
  1. 1.Department of Diagnostic and Interventional RadiologyUniversity of Leipzig—Heart CenterLeipzigGermany
  2. 2.Clinic of Heart SurgeryUniversity of Leipzig—Heart CenterLeipzigGermany
  3. 3.Siemens AGForchheimGermany
  4. 4.Department of CardiologyUniversity of Leipzig—Heart CenterLeipzigGermany
  5. 5.Department of Heart SurgeryKerckhoff-ClinicBad NauheimGermany

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