Classical methods to measure aortic valve area in the era of new invasive therapies: still accurate enough?

Delgado, Victoria; Bax, Jeroen J.

doi:10.1007/s10554-008-9365-6

Cited by 7 publications

(8 citation statements)

References 23 publications

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“…As part of the pre-operative assessment for the feasibility of a percutaneous trans-catheter approach, meticulous sizing and characterization of the aortic annulus anatomy, calcification burden, and relation to the adjacent structures, as well as the coronary anatomy and vascular access anatomy and patency are required. Of the cross-sectional modalities, MDCT can assess the above-mentioned criteria and may be of great value in this group of patients [14,50].…”

Section: Indications For Mdctmentioning

confidence: 99%

Aortic valve area: meta-analysis of diagnostic performance of multi-detector computed tomography for aortic valve area measurements as compared to transthoracic echocardiography

Shah

Novaro

Blandon

et al. 2009

Int J Cardiovasc Imaging

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Degenerative aortic valve stenosis (AS) has an incidence of 2-7% in the Western European and North American populations over 65 years of age. The aim of this study was to perform a meta-analysis of the published literature evaluating the accuracy of CT planimetry to measure the aortic valve area. The PUBMED and OVID databases were searched up to May 2008. Major criteria for article inclusion was the use of (a) multi-detector computed tomography as a diagnostic test for the assessment of AVA in patients with AS, and (b) TTE as the reference standard. Nine studies were included in the analysis with 175 women and 262 men. The mean AVA as measured by CT was 1.0 +/- 0.1. The mean AVA measured by TTE was 0.9 +/- 0.1. The correlation between CT and TTE AVA measurements was r = 1.45. The mean difference was 0.03 +/- 0.05. The results of our meta-analysis suggest that multi-detector CT is an accurate method for obtaining AVA measurements in patients with AS.

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Section: Indications For Mdctmentioning

confidence: 99%

Aortic valve area: meta-analysis of diagnostic performance of multi-detector computed tomography for aortic valve area measurements as compared to transthoracic echocardiography

Shah

Novaro

Blandon

et al. 2009

Int J Cardiovasc Imaging

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“…At present, different studies have confirmed that LVOT anatomy is more elliptic than circular; a significant decrease of the estimated LVOT area related to the area measured by planimetry [3][4][5][6] is also observable. This contributes to underestimate both larger and smaller LVOT diameters, which are essential for the correct choice of percutaneous prosthesis, increasing the risk of perivalvular leaks, and prosthesis migration, among other complications [7].…”

Section: Discussionmentioning

confidence: 99%

Dynamics of the Left Ventricular Outflow Tract during the Cardiac Cycle Assessed (with) Via Tridimensional Echocardiography

2015

JCCR

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Objective: To analyze the left ventricular outflow tract (LVOT) dynamic during cardiac cycle with 3D Echocardiography (3DEcho). Material and Methods:We prospectively included 58 patients sent to our lab for a transesophageal echocardiographic study (TEE). All TEE were done with a 3DEcho probe, obtaining gated images (4 beats, complete volume) for off-line analysis. The cardiac cycle was divided in proto (S1), mid (S2) and telesystole (S3); and proto (D1), mid (D2) and telediastole (D3). The LVOT area was measured by planimetric method in short axis, orthogonal to the long axis of the LVOT in each phase.Results: Mean age was 69.7±15 years, 60% male. LVOT area (cm 2 ) in each phases was: S1: 4,36±1,02; S2: 4.08±0,94; S3: 3,82±0,93; D1: 3,59±0,98; D2: 3,77±1,01; D3: 4,15±1,11. Maximal area was observed in S1, corresponding to the closing position of the anterior leaflet of the mitral valve (ALM) and a few excursion of the interventricular septum (IVS) to the LVOT; minimum area was obtained in D1 coinciding with some persistence of IVS in the LVOT and maximal opening position of ALM. The total modification of the area was 17±12% (p<0.0001), changing also the shape of the LVOT from a partially elliptical or circular one (systole) to an markedly elliptical or semilunar (diastole).Conclusion: the LVOT has a variation in area and shape during cardiac cycle, depending basically of the movement of IVS (systole) and mitral valve opening (diastole).

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“…The advent of new technologies such as the minimally invasive transcatheter AVR, which is still evolving, may result in a paradigm shift in treatment of severe AS in older adults 57 . This technique has been evaluated in multiple studies and has an implantation success rate in excess of 90% and a 30‐day and 1‐year survival rates of 82–95% and 70–80%, respectively, with most of the late mortality related to the abundance of comorbidities 58 . Percutaneous AVR also facilitates placement on top of the previous prosthetic valve if necessary.…”

Section: Management Of As In Older Adultsmentioning

confidence: 99%

“…57 This technique has been evaluated in multiple studies and has an implantation success rate in excess of 90% and a 30-day and 1-year survival rates of 82-95% and 70-80%, respectively, with most of the late mortality related to the abundance of comorbidities. 58 Percutaneous AVR also facilitates placement on top of the previous prosthetic valve if necessary. Recent gains in life expectancy with the use of mechanical valves may encourage their use in those who are at high-risk for surgical AVR and in asymptomatic patients with severe AS in the future.…”

Section: Management Of As In Older Adultsmentioning

confidence: 99%

Echocardiographic Evaluation of Calcific Aortic Stenosis in the Older Adult

et al. 2011

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Aortic stenosis is the most predominant valvular pathology occurring in older adults with an expected increase over time. Multiple comorbidities and highly variable clinical presentations which characterize the aging population necessitate the use of echocardiography in the assessment of valvular structure and real time hemodynamic evaluation. This article reviews the pathophysiology and clinical presentation of aortic stenosis in this unique population and the critical role of various echocardiographic modalities. The value of real time three-dimensional real time echocardiography in the assessment and management of aortic stenosis in older adults is emphasized.

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Classical methods to measure aortic valve area in the era of new invasive therapies: still accurate enough?

Cited by 7 publications

References 23 publications

Aortic valve area: meta-analysis of diagnostic performance of multi-detector computed tomography for aortic valve area measurements as compared to transthoracic echocardiography

Aortic valve area: meta-analysis of diagnostic performance of multi-detector computed tomography for aortic valve area measurements as compared to transthoracic echocardiography

Dynamics of the Left Ventricular Outflow Tract during the Cardiac Cycle Assessed (with) Via Tridimensional Echocardiography

Echocardiographic Evaluation of Calcific Aortic Stenosis in the Older Adult

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