Agreement Between 4D Transesophageal Echocardiography and Multi-detector Computed Tomography in Measuring Aortic Root Dimensions and Coronary Ostia Heights

Abstract

Purpose Multi-detector computed tomography (MDCT) is the gold standard non-invasive tool for evaluating aortic root dimensions. We assessed the agreement between 4D TEE and MDCT-derived aortic valve annular dimensions, coronary ostia height, and minor dimensions of sinuses of Valsalva (SoV) and sinotubular junction (STJ). Methods In this prospective analytical study, we measured the annular area, annular perimeter, area-derived diameter, area-derived perimeter, left and right coronary ostial heights, and minor diameters of the SoV and the STJ using ECG-gated MDCT and 4D TEE. TEE measurements were calculated semi-automatically by the eSie valve software. Results We enrolled 43 adult patients (27 males, median age: 46 years). We found strong correlations and good agreement between the two modalities in annular dimensions (area, perimeter, area-derived diameter, and perimeter-derived diameter), left coronary ostial height, minimum STJ diameter, and minimum SOV diameters. Moderate correlations, and agreement, with relatively large differences between the 95% LOA, were demonstrated for the right coronary artery ostial height. Conclusion 4D TEE correlates well with MDCT in measuring aortic annular dimensions, coronary ostial height, sinuses of Valsalva minor diameter, and sinotubular junction minor diameter. Whether this can affect clinical outcomes is unknown. It could replace MDCT if the latter is unavailable or contraindicated.