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Preoperative quantification of aortic valve stenosis: comparison of 64-slice computed tomography with transesophageal and transthoracic echocardiography and size of implanted prosthesis
Precise measurements of aortic complex diameters are essential for preoperative examinations of patients with aortic stenosis (AS) scheduled for aortic valve (AV) replacement. We aimed to prospectively compare the accuracy of transthoracic echocardiography (TTE), transoesophageal echocardiography (T...
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| Published in: | International Journal of Cardiovascular Imaging 2012-02, Vol.28 (2), p.343-352 |
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| container_end_page | 352 |
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| container_title | International Journal of Cardiovascular Imaging |
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| creator | Mizia-Stec, Katarzyna Pysz, Piotr Jasiński, Marek Adamczyk, Tomasz Drzewiecka-Gerber, Agnieszka Chmiel, Artur Krejca, Michał Bochenek, Andrzej Woś, Stanisław Sosnowski, Maciej Gąsior, Zbigniew Trusz-Gluza, Maria Tendera, Michał |
| description | Precise measurements of aortic complex diameters are essential for preoperative examinations of patients with aortic stenosis (AS) scheduled for aortic valve (AV) replacement. We aimed to prospectively compare the accuracy of transthoracic echocardiography (TTE), transoesophageal echocardiography (TEE) and multi-slice computed tomography (MSCT) measurements of the AV complex and to analyze the role of the multi-modality aortic annulus diameter (AAd) assessment in the selection of the optimal prosthesis to be implanted in patients surgically treated for degenerative AS. 20 patients (F/M: 3/17; age: 69 ± 6.5 years) with severe degenerative AS were enrolled into the study. TTE, TEE and MSCT including AV calcium score (AVCS) assessment were performed in all patients. The values of AAd obtained in the long AV complex axis (TTE, TEE, MSCT) and in multiplanar perpendicular imaging (MSCT) were compared to the size of implanted prosthesis. The mean AAd was 24 ± 3.6 mm using TTE, 26 ± 4.2 mm using TEE, and 26.9 ± 3.2 in MSCT (
P
= 0.04 vs. TTE). The mean diameter of the left ventricle out-flow tract in TTE (19.9 ± 2.7 mm) and TEE (19.5 ± 2.7 mm) were smaller than in MSCT (24.9 ± 3.3 mm,
P
|
| doi_str_mv | 10.1007/s10554-010-9784-z |
| format | article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_3288372</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>924963294</sourcerecordid><originalsourceid>FETCH-LOGICAL-c501t-58b7fb3e5465942856ca0325863faac3dc1cc33b1911fae619ac07012921fc3e3</originalsourceid><addsrcrecordid>eNp9Ustu1TAQjRCIlsIHsEERG7pJ62cSs0BCVYFKlcoC1tZcZ3LjKolT27mo98_4OxzSlocEK9szZ845Y50se0nJCSWkOg2USCkKQkmhqloU-0fZIZUVL0gl-OPlXqpCVkocZM9CuCaEMML40-yAUVapUvHD7Ptnj25CD9HuML-ZYYy2tSY93Zi7NgfnozX5DvrUDhFHF2x4mxs3TOBtWEGlKEJvDf4szxGbPLrBbT1M3W3-zcYujx7GgMFNHWwR-hzGZq3FznkwSQFN5wz4xt7PLZBg97gI2GHqk7NEPHmXZjCZeJ49aaEP-OLuPMq-fjj_cvapuLz6eHH2_rIwktBYyHpTtRuOUpRSCVbL0gDhTNYlbwEMbww1hvMNVZS2gCVVYEhFKFOMtoYjP8rerbzTvBmwMTgm472evB3A32oHVv_ZGW2nt26nOatrXrFE8OaOwLubGUPUgw0G-7QRujloxYQqOVMiIY__i6Sc8ZrUgi6kr_-CXrvZj-kjEl9SVSsfXUEm_Vrw2D64pkQvCdJrgnRKkF4SpPdp5tXv6z5M3EcmAdgKCKk1btH_Uv436w8UtthD</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>923729294</pqid></control><display><type>article</type><title>Preoperative quantification of aortic valve stenosis: comparison of 64-slice computed tomography with transesophageal and transthoracic echocardiography and size of implanted prosthesis</title><source>Springer Link</source><creator>Mizia-Stec, Katarzyna ; Pysz, Piotr ; Jasiński, Marek ; Adamczyk, Tomasz ; Drzewiecka-Gerber, Agnieszka ; Chmiel, Artur ; Krejca, Michał ; Bochenek, Andrzej ; Woś, Stanisław ; Sosnowski, Maciej ; Gąsior, Zbigniew ; Trusz-Gluza, Maria ; Tendera, Michał</creator><creatorcontrib>Mizia-Stec, Katarzyna ; Pysz, Piotr ; Jasiński, Marek ; Adamczyk, Tomasz ; Drzewiecka-Gerber, Agnieszka ; Chmiel, Artur ; Krejca, Michał ; Bochenek, Andrzej ; Woś, Stanisław ; Sosnowski, Maciej ; Gąsior, Zbigniew ; Trusz-Gluza, Maria ; Tendera, Michał</creatorcontrib><description>Precise measurements of aortic complex diameters are essential for preoperative examinations of patients with aortic stenosis (AS) scheduled for aortic valve (AV) replacement. We aimed to prospectively compare the accuracy of transthoracic echocardiography (TTE), transoesophageal echocardiography (TEE) and multi-slice computed tomography (MSCT) measurements of the AV complex and to analyze the role of the multi-modality aortic annulus diameter (AAd) assessment in the selection of the optimal prosthesis to be implanted in patients surgically treated for degenerative AS. 20 patients (F/M: 3/17; age: 69 ± 6.5 years) with severe degenerative AS were enrolled into the study. TTE, TEE and MSCT including AV calcium score (AVCS) assessment were performed in all patients. The values of AAd obtained in the long AV complex axis (TTE, TEE, MSCT) and in multiplanar perpendicular imaging (MSCT) were compared to the size of implanted prosthesis. The mean AAd was 24 ± 3.6 mm using TTE, 26 ± 4.2 mm using TEE, and 26.9 ± 3.2 in MSCT (
P
= 0.04 vs. TTE). The mean diameter of the left ventricle out-flow tract in TTE (19.9 ± 2.7 mm) and TEE (19.5 ± 2.7 mm) were smaller than in MSCT (24.9 ± 3.3 mm,
P
< 0.001 for both). The mean size of implanted prosthesis (22.2 ± 2.3 mm) was significantly smaller than the mean AAd measured by TTE (
P
= 0.0039), TEE (
P
= 0.0004), and MSCT (
P
< 0.0001). The implanted prosthesis size correlated significantly to the AAd: r = 0.603,
P
= 0.005 for TTE, r = 0.592,
P
= 0.006 for TEE, and r = 0.791,
P
< 0.001 for MSCT. Obesity and extensive valve calcification (AV calcium score ≥ 3177Ag.U.) were identified as potent factors that caused a deterioration of both TTE and MSCT performance. The accuracy of AAd measurements in TEE was only limited by AV calcification. In multivariate regression analysis the mean value of the minimum and maximum AAd obtained in MSCT-multiplanar perpendicular imaging was an independent factor (r = 0.802,
P
< 0.0001) predicting the size of implanted prosthesis. In patients with AS echocardiography remains the main diagnostics tool in clinical practice. MSCT as a 3-dimentional modality allows for accurate measurement of entire AV complex and facilitates optimal matching of prosthesis size.</description><identifier>ISSN: 1569-5794</identifier><identifier>EISSN: 1573-0743</identifier><identifier>EISSN: 1875-8312</identifier><identifier>DOI: 10.1007/s10554-010-9784-z</identifier><identifier>PMID: 21279693</identifier><identifier>CODEN: IJCIBI</identifier><language>eng</language><publisher>Dordrecht: Springer Netherlands</publisher><subject>Age ; Aged ; Aorta ; Aortic valve ; Aortic Valve - diagnostic imaging ; Aortic Valve - surgery ; Aortic Valve Stenosis - diagnostic imaging ; Aortic Valve Stenosis - surgery ; Calcification ; Calcification (ectopic) ; Calcium ; Cardiac Imaging ; Cardiology ; Computed tomography ; Echocardiography ; Echocardiography, Doppler ; Echocardiography, Transesophageal ; Female ; Heart Valve Prosthesis ; Heart Valve Prosthesis Implantation - instrumentation ; Humans ; Imaging ; Linear Models ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Multivariate Analysis ; Obesity ; Observer Variation ; Original Paper ; Poland ; Predictive Value of Tests ; Preoperative Care ; Prospective Studies ; Prosthesis Design ; Radiology ; Regression analysis ; Reproducibility of Results ; Severity of Illness Index ; Stenosis ; Tomography, X-Ray Computed ; Ventricle</subject><ispartof>International Journal of Cardiovascular Imaging, 2012-02, Vol.28 (2), p.343-352</ispartof><rights>The Author(s) 2011</rights><rights>Springer Science+Business Media, B.V. 2012</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c501t-58b7fb3e5465942856ca0325863faac3dc1cc33b1911fae619ac07012921fc3e3</citedby><cites>FETCH-LOGICAL-c501t-58b7fb3e5465942856ca0325863faac3dc1cc33b1911fae619ac07012921fc3e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21279693$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mizia-Stec, Katarzyna</creatorcontrib><creatorcontrib>Pysz, Piotr</creatorcontrib><creatorcontrib>Jasiński, Marek</creatorcontrib><creatorcontrib>Adamczyk, Tomasz</creatorcontrib><creatorcontrib>Drzewiecka-Gerber, Agnieszka</creatorcontrib><creatorcontrib>Chmiel, Artur</creatorcontrib><creatorcontrib>Krejca, Michał</creatorcontrib><creatorcontrib>Bochenek, Andrzej</creatorcontrib><creatorcontrib>Woś, Stanisław</creatorcontrib><creatorcontrib>Sosnowski, Maciej</creatorcontrib><creatorcontrib>Gąsior, Zbigniew</creatorcontrib><creatorcontrib>Trusz-Gluza, Maria</creatorcontrib><creatorcontrib>Tendera, Michał</creatorcontrib><title>Preoperative quantification of aortic valve stenosis: comparison of 64-slice computed tomography with transesophageal and transthoracic echocardiography and size of implanted prosthesis</title><title>International Journal of Cardiovascular Imaging</title><addtitle>Int J Cardiovasc Imaging</addtitle><addtitle>Int J Cardiovasc Imaging</addtitle><description>Precise measurements of aortic complex diameters are essential for preoperative examinations of patients with aortic stenosis (AS) scheduled for aortic valve (AV) replacement. We aimed to prospectively compare the accuracy of transthoracic echocardiography (TTE), transoesophageal echocardiography (TEE) and multi-slice computed tomography (MSCT) measurements of the AV complex and to analyze the role of the multi-modality aortic annulus diameter (AAd) assessment in the selection of the optimal prosthesis to be implanted in patients surgically treated for degenerative AS. 20 patients (F/M: 3/17; age: 69 ± 6.5 years) with severe degenerative AS were enrolled into the study. TTE, TEE and MSCT including AV calcium score (AVCS) assessment were performed in all patients. The values of AAd obtained in the long AV complex axis (TTE, TEE, MSCT) and in multiplanar perpendicular imaging (MSCT) were compared to the size of implanted prosthesis. The mean AAd was 24 ± 3.6 mm using TTE, 26 ± 4.2 mm using TEE, and 26.9 ± 3.2 in MSCT (
P
= 0.04 vs. TTE). The mean diameter of the left ventricle out-flow tract in TTE (19.9 ± 2.7 mm) and TEE (19.5 ± 2.7 mm) were smaller than in MSCT (24.9 ± 3.3 mm,
P
< 0.001 for both). The mean size of implanted prosthesis (22.2 ± 2.3 mm) was significantly smaller than the mean AAd measured by TTE (
P
= 0.0039), TEE (
P
= 0.0004), and MSCT (
P
< 0.0001). The implanted prosthesis size correlated significantly to the AAd: r = 0.603,
P
= 0.005 for TTE, r = 0.592,
P
= 0.006 for TEE, and r = 0.791,
P
< 0.001 for MSCT. Obesity and extensive valve calcification (AV calcium score ≥ 3177Ag.U.) were identified as potent factors that caused a deterioration of both TTE and MSCT performance. The accuracy of AAd measurements in TEE was only limited by AV calcification. In multivariate regression analysis the mean value of the minimum and maximum AAd obtained in MSCT-multiplanar perpendicular imaging was an independent factor (r = 0.802,
P
< 0.0001) predicting the size of implanted prosthesis. In patients with AS echocardiography remains the main diagnostics tool in clinical practice. MSCT as a 3-dimentional modality allows for accurate measurement of entire AV complex and facilitates optimal matching of prosthesis size.</description><subject>Age</subject><subject>Aged</subject><subject>Aorta</subject><subject>Aortic valve</subject><subject>Aortic Valve - diagnostic imaging</subject><subject>Aortic Valve - surgery</subject><subject>Aortic Valve Stenosis - diagnostic imaging</subject><subject>Aortic Valve Stenosis - surgery</subject><subject>Calcification</subject><subject>Calcification (ectopic)</subject><subject>Calcium</subject><subject>Cardiac Imaging</subject><subject>Cardiology</subject><subject>Computed tomography</subject><subject>Echocardiography</subject><subject>Echocardiography, Doppler</subject><subject>Echocardiography, Transesophageal</subject><subject>Female</subject><subject>Heart Valve Prosthesis</subject><subject>Heart Valve Prosthesis Implantation - instrumentation</subject><subject>Humans</subject><subject>Imaging</subject><subject>Linear Models</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Multivariate Analysis</subject><subject>Obesity</subject><subject>Observer Variation</subject><subject>Original Paper</subject><subject>Poland</subject><subject>Predictive Value of Tests</subject><subject>Preoperative Care</subject><subject>Prospective Studies</subject><subject>Prosthesis Design</subject><subject>Radiology</subject><subject>Regression analysis</subject><subject>Reproducibility of Results</subject><subject>Severity of Illness Index</subject><subject>Stenosis</subject><subject>Tomography, X-Ray Computed</subject><subject>Ventricle</subject><issn>1569-5794</issn><issn>1573-0743</issn><issn>1875-8312</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><recordid>eNp9Ustu1TAQjRCIlsIHsEERG7pJ62cSs0BCVYFKlcoC1tZcZ3LjKolT27mo98_4OxzSlocEK9szZ845Y50se0nJCSWkOg2USCkKQkmhqloU-0fZIZUVL0gl-OPlXqpCVkocZM9CuCaEMML40-yAUVapUvHD7Ptnj25CD9HuML-ZYYy2tSY93Zi7NgfnozX5DvrUDhFHF2x4mxs3TOBtWEGlKEJvDf4szxGbPLrBbT1M3W3-zcYujx7GgMFNHWwR-hzGZq3FznkwSQFN5wz4xt7PLZBg97gI2GHqk7NEPHmXZjCZeJ49aaEP-OLuPMq-fjj_cvapuLz6eHH2_rIwktBYyHpTtRuOUpRSCVbL0gDhTNYlbwEMbww1hvMNVZS2gCVVYEhFKFOMtoYjP8rerbzTvBmwMTgm472evB3A32oHVv_ZGW2nt26nOatrXrFE8OaOwLubGUPUgw0G-7QRujloxYQqOVMiIY__i6Sc8ZrUgi6kr_-CXrvZj-kjEl9SVSsfXUEm_Vrw2D64pkQvCdJrgnRKkF4SpPdp5tXv6z5M3EcmAdgKCKk1btH_Uv436w8UtthD</recordid><startdate>20120201</startdate><enddate>20120201</enddate><creator>Mizia-Stec, Katarzyna</creator><creator>Pysz, Piotr</creator><creator>Jasiński, Marek</creator><creator>Adamczyk, Tomasz</creator><creator>Drzewiecka-Gerber, Agnieszka</creator><creator>Chmiel, Artur</creator><creator>Krejca, Michał</creator><creator>Bochenek, Andrzej</creator><creator>Woś, Stanisław</creator><creator>Sosnowski, Maciej</creator><creator>Gąsior, Zbigniew</creator><creator>Trusz-Gluza, Maria</creator><creator>Tendera, Michał</creator><general>Springer Netherlands</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M7Z</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7QO</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20120201</creationdate><title>Preoperative quantification of aortic valve stenosis: comparison of 64-slice computed tomography with transesophageal and transthoracic echocardiography and size of implanted prosthesis</title><author>Mizia-Stec, Katarzyna ; Pysz, Piotr ; Jasiński, Marek ; Adamczyk, Tomasz ; Drzewiecka-Gerber, Agnieszka ; Chmiel, Artur ; Krejca, Michał ; Bochenek, Andrzej ; Woś, Stanisław ; Sosnowski, Maciej ; Gąsior, Zbigniew ; Trusz-Gluza, Maria ; Tendera, Michał</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c501t-58b7fb3e5465942856ca0325863faac3dc1cc33b1911fae619ac07012921fc3e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Age</topic><topic>Aged</topic><topic>Aorta</topic><topic>Aortic valve</topic><topic>Aortic Valve - diagnostic imaging</topic><topic>Aortic Valve - surgery</topic><topic>Aortic Valve Stenosis - diagnostic imaging</topic><topic>Aortic Valve Stenosis - surgery</topic><topic>Calcification</topic><topic>Calcification (ectopic)</topic><topic>Calcium</topic><topic>Cardiac Imaging</topic><topic>Cardiology</topic><topic>Computed tomography</topic><topic>Echocardiography</topic><topic>Echocardiography, Doppler</topic><topic>Echocardiography, Transesophageal</topic><topic>Female</topic><topic>Heart Valve Prosthesis</topic><topic>Heart Valve Prosthesis Implantation - instrumentation</topic><topic>Humans</topic><topic>Imaging</topic><topic>Linear Models</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Multivariate Analysis</topic><topic>Obesity</topic><topic>Observer Variation</topic><topic>Original Paper</topic><topic>Poland</topic><topic>Predictive Value of Tests</topic><topic>Preoperative Care</topic><topic>Prospective Studies</topic><topic>Prosthesis Design</topic><topic>Radiology</topic><topic>Regression analysis</topic><topic>Reproducibility of Results</topic><topic>Severity of Illness Index</topic><topic>Stenosis</topic><topic>Tomography, X-Ray Computed</topic><topic>Ventricle</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mizia-Stec, Katarzyna</creatorcontrib><creatorcontrib>Pysz, Piotr</creatorcontrib><creatorcontrib>Jasiński, Marek</creatorcontrib><creatorcontrib>Adamczyk, Tomasz</creatorcontrib><creatorcontrib>Drzewiecka-Gerber, Agnieszka</creatorcontrib><creatorcontrib>Chmiel, Artur</creatorcontrib><creatorcontrib>Krejca, Michał</creatorcontrib><creatorcontrib>Bochenek, Andrzej</creatorcontrib><creatorcontrib>Woś, Stanisław</creatorcontrib><creatorcontrib>Sosnowski, Maciej</creatorcontrib><creatorcontrib>Gąsior, Zbigniew</creatorcontrib><creatorcontrib>Trusz-Gluza, Maria</creatorcontrib><creatorcontrib>Tendera, Michał</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biochemistry Abstracts 1</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>Biotechnology Research Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>International Journal of Cardiovascular Imaging</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mizia-Stec, Katarzyna</au><au>Pysz, Piotr</au><au>Jasiński, Marek</au><au>Adamczyk, Tomasz</au><au>Drzewiecka-Gerber, Agnieszka</au><au>Chmiel, Artur</au><au>Krejca, Michał</au><au>Bochenek, Andrzej</au><au>Woś, Stanisław</au><au>Sosnowski, Maciej</au><au>Gąsior, Zbigniew</au><au>Trusz-Gluza, Maria</au><au>Tendera, Michał</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Preoperative quantification of aortic valve stenosis: comparison of 64-slice computed tomography with transesophageal and transthoracic echocardiography and size of implanted prosthesis</atitle><jtitle>International Journal of Cardiovascular Imaging</jtitle><stitle>Int J Cardiovasc Imaging</stitle><addtitle>Int J Cardiovasc Imaging</addtitle><date>2012-02-01</date><risdate>2012</risdate><volume>28</volume><issue>2</issue><spage>343</spage><epage>352</epage><pages>343-352</pages><issn>1569-5794</issn><eissn>1573-0743</eissn><eissn>1875-8312</eissn><coden>IJCIBI</coden><abstract>Precise measurements of aortic complex diameters are essential for preoperative examinations of patients with aortic stenosis (AS) scheduled for aortic valve (AV) replacement. We aimed to prospectively compare the accuracy of transthoracic echocardiography (TTE), transoesophageal echocardiography (TEE) and multi-slice computed tomography (MSCT) measurements of the AV complex and to analyze the role of the multi-modality aortic annulus diameter (AAd) assessment in the selection of the optimal prosthesis to be implanted in patients surgically treated for degenerative AS. 20 patients (F/M: 3/17; age: 69 ± 6.5 years) with severe degenerative AS were enrolled into the study. TTE, TEE and MSCT including AV calcium score (AVCS) assessment were performed in all patients. The values of AAd obtained in the long AV complex axis (TTE, TEE, MSCT) and in multiplanar perpendicular imaging (MSCT) were compared to the size of implanted prosthesis. The mean AAd was 24 ± 3.6 mm using TTE, 26 ± 4.2 mm using TEE, and 26.9 ± 3.2 in MSCT (
P
= 0.04 vs. TTE). The mean diameter of the left ventricle out-flow tract in TTE (19.9 ± 2.7 mm) and TEE (19.5 ± 2.7 mm) were smaller than in MSCT (24.9 ± 3.3 mm,
P
< 0.001 for both). The mean size of implanted prosthesis (22.2 ± 2.3 mm) was significantly smaller than the mean AAd measured by TTE (
P
= 0.0039), TEE (
P
= 0.0004), and MSCT (
P
< 0.0001). The implanted prosthesis size correlated significantly to the AAd: r = 0.603,
P
= 0.005 for TTE, r = 0.592,
P
= 0.006 for TEE, and r = 0.791,
P
< 0.001 for MSCT. Obesity and extensive valve calcification (AV calcium score ≥ 3177Ag.U.) were identified as potent factors that caused a deterioration of both TTE and MSCT performance. The accuracy of AAd measurements in TEE was only limited by AV calcification. In multivariate regression analysis the mean value of the minimum and maximum AAd obtained in MSCT-multiplanar perpendicular imaging was an independent factor (r = 0.802,
P
< 0.0001) predicting the size of implanted prosthesis. In patients with AS echocardiography remains the main diagnostics tool in clinical practice. MSCT as a 3-dimentional modality allows for accurate measurement of entire AV complex and facilitates optimal matching of prosthesis size.</abstract><cop>Dordrecht</cop><pub>Springer Netherlands</pub><pmid>21279693</pmid><doi>10.1007/s10554-010-9784-z</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1569-5794 |
| ispartof | International Journal of Cardiovascular Imaging, 2012-02, Vol.28 (2), p.343-352 |
| issn | 1569-5794 1573-0743 1875-8312 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_3288372 |
| source | Springer Link |
| subjects | Age Aged Aorta Aortic valve Aortic Valve - diagnostic imaging Aortic Valve - surgery Aortic Valve Stenosis - diagnostic imaging Aortic Valve Stenosis - surgery Calcification Calcification (ectopic) Calcium Cardiac Imaging Cardiology Computed tomography Echocardiography Echocardiography, Doppler Echocardiography, Transesophageal Female Heart Valve Prosthesis Heart Valve Prosthesis Implantation - instrumentation Humans Imaging Linear Models Male Medicine Medicine & Public Health Middle Aged Multivariate Analysis Obesity Observer Variation Original Paper Poland Predictive Value of Tests Preoperative Care Prospective Studies Prosthesis Design Radiology Regression analysis Reproducibility of Results Severity of Illness Index Stenosis Tomography, X-Ray Computed Ventricle |
| title | Preoperative quantification of aortic valve stenosis: comparison of 64-slice computed tomography with transesophageal and transthoracic echocardiography and size of implanted prosthesis |
| url | http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-28T17%3A22%3A23IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Preoperative%20quantification%20of%20aortic%20valve%20stenosis:%20comparison%20of%2064-slice%20computed%20tomography%20with%20transesophageal%20and%20transthoracic%20echocardiography%20and%20size%20of%20implanted%20prosthesis&rft.jtitle=International%20Journal%20of%20Cardiovascular%20Imaging&rft.au=Mizia-Stec,%20Katarzyna&rft.date=2012-02-01&rft.volume=28&rft.issue=2&rft.spage=343&rft.epage=352&rft.pages=343-352&rft.issn=1569-5794&rft.eissn=1573-0743&rft.coden=IJCIBI&rft_id=info:doi/10.1007/s10554-010-9784-z&rft_dat=%3Cproquest_pubme%3E924963294%3C/proquest_pubme%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c501t-58b7fb3e5465942856ca0325863faac3dc1cc33b1911fae619ac07012921fc3e3%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=923729294&rft_id=info:pmid/21279693&rfr_iscdi=true |