Retrospectively ECG-gated helical vs. non-ECG-synchronized high-pitch CTA of the aortic root for TAVI planning

Multidetector computed tomography (MDCT) plays a key role in patient assessment prior to transcatheter aortic valve implantation (TAVI). However, to date no consensus has been established on what is the optimal pre-procedural imaging protocol. Variability in pre-TAVI acquisition protocols may lead t...

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Bibliographic Details
Published in:PloS one 2020-05, Vol.15 (5), p.e0232673-e0232673
Main Authors: Horehledova, Barbora, Mihl, Casper, Boswijk, Ellen, Crombag, Genevieve A J C, Nijssen, Estelle C, Nelemans, Patty J, Veenstra, Leo F, Wildberger, Joachim E, Das, Marco
Format: Article
Language:English
Subjects:
Angiography
Annuli
Aorta
Aortic valve
Biology and Life Sciences
CAT scans
Computed tomography
Contrast agents
Coronary vessels
Diagnostic imaging
Diastole
Dimensional changes
EKG
Electrocardiography
Engineering and Technology
Ethics
Evaluation
Heart rate
Heart valve diseases
Heart valve replacement
Heart valves
Image acquisition
Implantation
Iopromide
Medical imaging
Medicine and Health Sciences
Methods
Noise
Nuclear medicine
Patients
Preoperative care
Prostheses
Prostheses and implants
Research and Analysis Methods
Statistical analysis
Systole
Tomography
Variance analysis
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Summary:Multidetector computed tomography (MDCT) plays a key role in patient assessment prior to transcatheter aortic valve implantation (TAVI). However, to date no consensus has been established on what is the optimal pre-procedural imaging protocol. Variability in pre-TAVI acquisition protocols may lead to discrepancies in aortic annulus measurements and may potentially influence prosthesis size selection. The current study evaluates the magnitude of differences in aortic annulus measurements using max-systolic, end-diastolic, and non-ECG-synchronized imaging, as well as the impact of method on prosthesis size selection. Fifty consecutive TAVI-candidates, who underwent retrospectively-ECG-gated CT angiography (CTA) of the aortic root, directly followed by non-ECG-synchronized high-pitch CT of the entire aorta, were retrospectively included. Aortic root dimensions were assessed at each 10% increment of the R-R interval (0-100%) and on the non-ECG-synchronized scan. Dimensional changes within the cardiac cycle were evaluated using a 1-way repeated ANOVA. Agreement in measurements between max-systole, end-diastole and non-ECG-synchronized scans was assessed with Bland-Altman analysis. Maximal dimensions of the aortic root structures and minimum annulus-coronary ostia distances were measured during systole. Max-systolic measurements were significantly and substantially larger than end-diastolic (p
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0232673