Dataset Information


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

ABSTRACT: BACKGROUND: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. PURPOSE: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. MATERIAL AND METHODS: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. RESULTS: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<0.001) and non-ECG-synchronized measurements (p<0.001). Due to these discrepancies, the three methods resulted in the same prosthesis size selection in only 48-62% of patients. CONCLUSIONS:The systematic differences between max-systolic, end-diastolic and non-ECG-synchronized measurements for relevant aortic annular dimensions are both statistically significant and clinically relevant. Imaging strategy impacts prosthesis size selection in nearly half the TAVI-candidates. End-diastolic and non-ECG-synchronized imaging does not provide optimal information for prosthesis size selection. Systolic image acquisition is necessary for assessment of maximal annular dimensions and minimum annulus-coronary ostia distances.

SUBMITTER: Horehledova B 

PROVIDER: S-EPMC7217477 | BioStudies | 2020-01-01

REPOSITORIES: biostudies

Similar Datasets

2014-01-01 | S-EPMC4118882 | BioStudies
2020-01-01 | S-EPMC7329903 | BioStudies
2019-01-01 | S-EPMC6932792 | BioStudies
1000-01-01 | S-EPMC5067813 | BioStudies
2018-01-01 | S-EPMC6242918 | BioStudies
2019-01-01 | S-EPMC6875021 | BioStudies
2018-01-01 | S-EPMC6023104 | BioStudies
2017-01-01 | S-EPMC5590871 | BioStudies
1000-01-01 | S-EPMC6149591 | BioStudies
2021-01-01 | S-EPMC7843714 | BioStudies