%0 Journal Article
%T Transesophageal echocardiography measurements of aortic annulus diameter using biplane mode in patients undergoing transcatheter aortic valve implantation
%A Kambiz Shahgaldi
%A Cristina da Silva
%A Magnus B£¿ck
%A Andreas R¨¹ck
%A Aristomenis Manouras
%A Anders Sahl¨¦n
%J Cardiovascular Ultrasound
%D 2013
%I BioMed Central
%R 10.1186/1476-7120-11-5
%X Aim of the study is to assess the aortic annulus diameter in patients undergoing TAVI by biplane (BP) mode using transesophageal echocardiography (TEE) and compare it to two-dimensional (2D) transthoracic echocardiography (TTE) and 2DTEE using three-dimensional (3D) TEE as reference method.The study population consisted of 50 patients retrospectively (24 men and 26 women, mean age 85+/-8 years of age) who all had undergone echocardiography examination prior to TAVI.The mean aortic annulus diameter was 20.4+/-2.2 mm with TTE, 22.3+/-2.5 mm with 2DTEE, 22.9+/-1.9 mm with BP-mode and 23.1+/-1.9 mm with 3DTEE. TTE underestimated the mean aortic annulus diameter in comparison to transesophageal imaging modalities (p<0.001). Using 3DTEE, 2% of patients were unsuitable for TAVI due to a too-small AoA (n=1). This figure was similar with BP (4%, n=2; p=1.00) but considerably larger with 2DTTE (36%, n=18; p < 0.001) and 2DTEE (12%, n=6; p=0.06). There was a strong correlation between BP-mode and 3DTEE for assessment of aortic annulus diameter (r-value 0.88) with small mean difference (-0.2+/-0.9 mm) whereas the other modalities showed larger 95% confidence interval and modest correlation (2DTTE vs. 3DTEE, -6.3 to 0.9 mm, r=0.64 and 2DTEE vs. 3DTEE, -4.8 to 3.2 mm, r=0.61).A multi-dimensional method is preferred to assess aortic annulus diameter in TAVI patients since there is risk of underestimation using single plane. Biplane mode is the method of choice in view of speedy post-processing with no need for expensive dedicated software. Lastly, single plane methods lead to misclassification of patients as unsuitable for TAVI. This may be of major clinical importance.
%U http://www.cardiovascularultrasound.com/content/11/1/5/abstract