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Revista chilena de cardiología

versión On-line ISSN 0718-8560

Resumen

IBANEZ-ARENAS, Rodrigo et al. Correlation between 3-D trans-esophageal echocardiography and Cardiac Computed tomography in the evaluation of the aortic annulus prior to Transcatheter aortic Valve implantation (TAVR). Rev Chil Cardiol [online]. 2015, vol.34, n.1, pp.28-35. ISSN 0718-8560.  http://dx.doi.org/10.4067/S0718-85602015000100003.

In TAVR, the precise measuring of the aortic annulus is essential to determine the size of the prosthesis and to avoid complications like rupture of the annulus of aortic insufficiency. Computed tomography (CT) is the gold standard to achieve these goals. 3-D trans-esophageal echocardiography (3-D TEE) to be a useful alternative method. Aim: to evaluate the correlation of aortic annulus measurements obtained with 3-dTE and CT in the determination of annulus measurements before TAVR. Prosthesis size and presence of aortic insufficiency were related to these measurements. Methods: In a retrospective blinded protocol the measurements of the aortic annulus obtained with CT or 3D-TEE were correlated in 18 consecutive patients (mean age 82 ± 7.1) submitted to TAVR with a Sapien XT (Edwards Lifescience) prosthesis. Maximal, minimal and mean diameters as well as area and annular circumference were evaluated. Results: Compared to CT, 3D-TEE under estimated de size of the aortic annulus but correlated well with other measurements of CT, especially with the annular circumference. Measurements from both methods agreed in the determination of the prosthesis size in 17 of 18 patients. No significant per prosthetic aortic insufficiency was observed in any case. Conclusion: 3DTEE correlates well with CT in evaluating the different parameters of the aortic annulus and is a good alternative to CT in complex cases and when CT is not readily available.

Palabras clave : Three dimensional echocardiography; aortic valve; multidetector computed tomography; aortic stenosis; transcatheter aortic valve implantation.

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