Accuracy and reproducibility of novel echocardiographic three-dimensional automated software for the assessment of the aortic root in candidates for thanscatheter aortic valve replacement

García-Martín, Ana; Lázaro-Rivera, Carla; Fernández-Golfín, Covadonga; Salido-Tahoces, Luisa; Moya-Mur, José-Luis; Jiménez-Nacher, José Julio; Casas-Rojo, Eduardo; Aquila, Iolanda; González-Gómez, A; Hernández‐Antolín, Rosana; Zamorano, José Luís

doi:10.1093/ehjci/jev204

Cited by 24 publications

(19 citation statements)

References 25 publications

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“…Indeed, our group demonstrated that this automatic software allows modeling and quantification of the aortic root from 3D TEE data with high reproducibility in patients who underwent transcatheter aortic valve implantation. [13] Yet a direct evaluation through cardiac surgery confirmation would be needed to assess accuracy of the software measurements. In the present study, we aimed at providing a correct and complete assessment of the anatomy as well as of the dynamic MA geometry and displacement in the 3D space, showing annular characteristics and dynamics abnormal in both FMR and OMR.…”

Section: Discussionmentioning

confidence: 99%

“…[11–13] It allows fast and automatic quantitation of different MV components from 3D TEE images, with minimal human intervention, and seems to overcome many of the limitations of available software so far. Thus, the aim of the present study was to evaluate the feasibility of this new software to analyze MA dynamics in significant FMR and OMR and to correctly identify each of them, to provide additional noncurrently available parameters of MV function with possible clinical impact, and to evaluate reproducibility and time to perform the full analysis as a surrogate of its potential clinical applicability.…”

Section: Introductionmentioning

confidence: 99%

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Fully automated software for mitral annulus evaluation in chronic mitral regurgitation by 3-dimensional transesophageal echocardiography

et al. 2016

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Three-dimensional (3D) transesophageal echocardiography (TEE) is the gold standard for mitral valve (MV) anatomic and functional evaluation. Currently, dedicated MV analysis software has limitations for its use in clinical practice. Thus, we tested here a complete and reproducible evaluation of a new fully automatic software to characterize MV anatomy in different forms of mitral regurgitation (MR) by 3D TEE.Sixty patients were included: 45 with more than moderate MR (28 organic MR [OMR] and 17 functional MR [FMR]) and 15 controls. All patients underwent TEE. 3D MV images obtained using 3D zoom were imported into the new software for automatic analysis. Different MV parameters were obtained and compared. Anatomic and dynamic differences between FMR and OMR were detected. A significant increase in systolic (859.75 vs 801.83 vs 607.78 mm2; P = 0.002) and diastolic (1040.60 vs. 1217.83 and 859.74 mm2; P < 0.001) annular sizes was observed in both OMR and FMR compared to that in controls. FMR had a reduced mitral annular contraction compared to degenerative cases of OMR and to controls (17.14% vs 32.78% and 29.89%; P = 0.007). Good reproducibility was demonstrated along with a short analysis time (mean 4.30 minutes).Annular characteristics and dynamics are abnormal in both FMR and OMR. Full 3D software analysis automatically calculates several significant parameters that provide a correct and complete assessment of anatomy and dynamic mitral annulus geometry and displacement in the 3D space. This analysis allows a better characterization of MR pathophysiology and could be useful in designing new devices for MR repair or replacement.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Fully automated software for mitral annulus evaluation in chronic mitral regurgitation by 3-dimensional transesophageal echocardiography

et al. 2016

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“…A promising version of reconstruction software that generates a geometric model of the aortic root from 3D TOE images and then performs quantitative analysis of these structures has been validated in a small pilot study against both standard 3D TOE and MDCT (33). There is also emerging computational modelling software that predicts the in vivo morphology of the implanted valve via finite element computer simulation.…”

Section: What Does the Future Hold?mentioning

confidence: 99%

3D transoesophageal echocardiography in the TAVI sizing arena: should we do it and how do we do it?

Bleakley¹,

Eskandari²,

Monaghan³

2017

Echo Research and Practice

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Transcatheter aortic valve implantation (TAVI) was initially proven as an alternative to valve replacement therapy in those beyond established risk thresholds for conventional surgery. With time the technique has been methodically refined and offered to a progressively lower risk cohort, and with this evolution has come that of the significant imaging requirements of valve implantation. This review discusses the role of transoesophageal echocardiography (TOE) in the current TAVI arena, aligning it with that of cardiac computed tomography, and outlining how TOE can be used most effectively both prior to and during TAVI in order to optimise outcomes.

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“…Observational studies have been performed to compare 3D transesophageal echocardiography (3DTEE) with MDCT for annular sizing. This stems from the fact that contrast used in MDCT in pre‐TAVR aortic annulus sizing can induce kidney injury in as many as 7% to 10.5% of patients and the risk of this complication is much higher if the patient has pre‐existing renal impairment . Renal impairment in pre‐TAVR setting has been demonstrated as a pivotal predictor of morbidity and mortality …”

Section: Introductionmentioning

confidence: 99%

Three‐dimensional transesophageal echocardiography is an attractive alternative to cardiac multi‐detector computed tomography for aortic annular sizing: Systematic review and meta‐analysis

et al. 2018

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Background Cardiac imaging is the cornerstone of the pretranscatheter aortic valve replacement (TAVR) assessment. Multi‐detector computed tomography (MDCT) is considered the conventional imaging modality. However, there is still no definitive gold standard. Targeted cohort of inoperable high‐risk patients with underlying comorbidities, particularly renal impairment, makes apparent the need for MDCT alternative. We aimed to demonstrate the correlation extent between MDCT and three‐dimensional transesophageal echocardiography (3DTEE) aortic annular area measures and to answer the question: Is 3DTEE a good alternative to MDCT? Methods A systematic literature search and meta‐analysis were conducted to evaluate the degree of correlation and agreement between 3DTEE and MDCT aortic annular sizing. A thorough assessment of EMBASE, PubMed, and Cochrane Central Register of Controlled Trials (CENTRAL) was performed. All studies comparing 3DTEE and MDCT in relation to aortic annular sizing were included. Results Thirteen studies were included (N = 1228 patients). A strong linear correlation was found between 3DTEE and MDCT measurements of aortic annulus area (r = 0.84, P < 0.001), mean perimeter (r = 0. 0.85, P < 0.001), and mean diameter (r = 0.80, P < 0.001). Bland–Altman plots revealed smaller mean 3DTEE values in comparison to MDCT for aortic annular area, the mean difference being −2.22 mm2 with 95% limits of agreement −12.79 to 8.36. Conclusion Aortic annulus measurements obtained by 3DTEE demonstrated a high level of correlation with those evaluated by MDCT. This makes 3DTEE a feasible choice for aortic annulus assessment, with advantage of real time assessment, lack of contrast, and no radiation exposure.

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Accuracy and reproducibility of novel echocardiographic three-dimensional automated software for the assessment of the aortic root in candidates for thanscatheter aortic valve replacement

Cited by 24 publications

References 25 publications

Fully automated software for mitral annulus evaluation in chronic mitral regurgitation by 3-dimensional transesophageal echocardiography

Fully automated software for mitral annulus evaluation in chronic mitral regurgitation by 3-dimensional transesophageal echocardiography

3D transoesophageal echocardiography in the TAVI sizing arena: should we do it and how do we do it?

Three‐dimensional transesophageal echocardiography is an attractive alternative to cardiac multi‐detector computed tomography for aortic annular sizing: Systematic review and meta‐analysis

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