Accuracy of intracardiac echocardiography for aortic root assessment in patients undergoing transcatheter aortic valve implantation
| Autor: | Valeria Cammalleri, Corrado Tamburino, Anna Maria Pistritto, Gaetano Zingali, Simona Gulino, Sebastiano Immè, Kunal Sarkar, Marilena Scarabelli, Massimiliano Mulè, Wanda Deste, Marco Barbanti, Patrizia Aruta, Miriam Cumbo, Valeria Garretto, Gian Paolo Ussia, Salvatore Scandura |
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| Rok vydání: | 2012 |
| Předmět: |
Adult
Male medicine.medical_specialty Intracardiac echocardiography Transcatheter aortic Aortic root Settore MED/11 - Malattie dell'Apparato Cardiovascolare Multidetector Computed Tomography Humans Medicine In patient Prospective Studies Cardiac skeleton Ultrasonography Interventional Ultrasonography Heart Valve Prosthesis Implantation Reproducibility Interventional business.industry Reproducibility of Results Aortic Valve Stenosis Sinus of Valsalva medicine.disease Stenosis Echocardiography Aortic Valve Female cardiovascular system Radiology Cardiology and Cardiovascular Medicine Complication business |
| Zdroj: | American Heart Journal. 163:684-689 |
| ISSN: | 0002-8703 |
| DOI: | 10.1016/j.ahj.2012.01.008 |
| Popis: | Multislice computed tomography (MSCT) has generally been accepted as the most accurate modality fulfilling this purpose with good reproducibility. A major drawback of MSCT consists in the use of contrast dye, which may be unsafe in transcatheter aortic valve implantation (TAVI) patients who frequently are affected by renal failure. We sought to appraise the accuracy of intracardiac echocardiography (ICE) in measurements of structures in the aortic root in patients undergoing TAVI.Aortic annulus and sinus of Valsalva diameters were measured using ICE, performed during standard invasive preprocedural assessment in 30 consecutive patients with severe aortic stenosis referred for TAVI. Multislice computed tomography was performed in all patients afterward, and aortic root measurements were made by an independent radiologist.Effective ICE measurements were obtained in all patients, easily and without any complication. Mean aortic annulus diameters were 21.9 ± 1.8 mm using ICE, 22.0 ± 1.9 mm using MSCT (3-chamber [3-C] view) and 22.8 ± 1.8 mm using the mean of long-axis and short-axis (L-ax/S-ax) view MSCT (P = .192, ICE vs 3-C MSCT; P.001, ICE vs L-ax/S-ax MSCT, respectively). Correlation between ICE and both MSCT measurements was good (r(2) = 0.83, P.001; r(2) = 0.80, P.001, respectively). Mean sinus of Valsalva diameters were 32.3 ± 3.3 mm using ICE and 32.5 ± 3.1 mm using 3-C MSCT view (P = .141). Even in this case, correlation between ICE and both MSCT measurements was excellent (r(2) = 0.96, P.001).In patients referred for TAVI, measurements of the aortic annulus and the sinus of Valsalva using ICE compare favorably with those made at MSCT. This approach might be a useful and reproducible strategy in patients with severe renal impairment to avoid the administration of contrast dye during MSCT. |
| Databáze: | OpenAIRE |
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