O-32 Transthoracic and transoesophageal echocardiographic measurement of the aortic annulus in transcatheter aortic valve Implantation (TAVI)

IntroductionThe evaluation of the aortic annulus is crucial in patients scheduled for transcatheter aortic valve implantation (TAVI). The measurements are performed with transthoracic (TTE) or transoesophageal (TOE) echocardiography, or computed tomography. In this study we compared TTE and TOE accuracy in measuring aortic annulus diameter.MethodEighty-four consecutive patients undergoing TAVI were enrolled in the study. All patients underwent preoperative TTE and TOE during surgery. All measurements were performed by the same skilled (MM, GT) echocardiographers. A paired t-test and Pearson's correlation were used for the comparisons of measurements obtained with the two methods; Bland-Altman analysis was used to evaluate error and bias. P<0.05 was considered significant.ResultsMean aortic annulus diameter was 20.96 ± 1.78 mm using TTE, and 21.95 ± 1.76 mm using TOE (P<0.0001). Correlation between TTE and TOE was moderate (r=0.56; P<0.001), and Bland-Altman plot displayed smaller diameters when using TTE rather than TOE (mean differences 0.99 mm, limits of agreement 4.2 to −2.3) (Fig 1), The regression analysis of the data of the Bland-Altman plot gave a non significant (P=0.88) result.ConclusionsIn default of a gold standard method for the assessment of aortic annulus in TAVI, our study shows a moderate correlation between TTE and TOE, thus confirming previous findings. Moreover regression analysis in the Bland-Altman plot showed no statistically significant differences between the two techniques.(1Messika-Zeitoun D. Serfaty J.M. Brochet E. et al.Multimodal assessment of the aortic annulus diameter: implications for transcatheter aortic valve implantation.J Am Coll Cardiol. 2010; 55: 186-194Abstract Full Text Full Text PDF PubMed Scopus (370) Google Scholar) IntroductionThe evaluation of the aortic annulus is crucial in patients scheduled for transcatheter aortic valve implantation (TAVI). The measurements are performed with transthoracic (TTE) or transoesophageal (TOE) echocardiography, or computed tomography. In this study we compared TTE and TOE accuracy in measuring aortic annulus diameter.