Ascending aorta measurements as assessed by ECG-gated multi-detector computed tomography: a pilot study to establish normative values for transcatheter therapies

Abstract

Ascending aorta measurements as assessed by ECG-gated multi-detector computed tomography: a pilot study to establish normative values for transcatheter therapies Abstract The aim of this study was to provide an insight into normative values of the ascending aorta in regards to novel endovascular procedures using ECG-gated multi-detector CT angiography. Seventy-seven adult patients without ascending aortic abnormalities were evaluated. Measurements at relevant levels of the aortic root and ascending aorta were obtained. Diameter variations of the ascending aorta during cardiac cycle were also considered. Mean diameters (mm) were as follows: LV outflow tract 20.3±3.4, coronary sinus 34.2±4.1, sino-tubular junction 29.7±3.4 and mid ascending aorta 32.7±3.8 with coefficients of variation (CV) ranging from 12 to 17%. Mean distances (mm) were: from the plane passing through the proximal insertions of the aortic valve cusps to the right brachio-cephalic artery (BCA) 92.6±11.8, from the plane passing through the proximal insertions of the aortic valve cusps to the proximal coronary ostium 12.1±3.7, and between both coronary ostia 7.2±3.1, minimal arc of the ascending aorta from left coronary ostium to right BCA 52.9 ±9.5, and the fibrous continuity between the aortic valve and the anterior leaflet of the mitral valve 14.6±3.3, CV 13-43%. Mean aortic valve area was 582.0±131.9 mm 2 . The variation of the antero-posterior and transverse diameters of the ascending aorta during the cardiac cycle were 8.4% and 7.3%, respectively. Results showed large inter-individual variations in diameters and distances but with limited intra-individual variations during the cardiac cycle. A personalized approach for planning endovascular devices must be considered.

Dual source multidetector CT-angiography before Transcatheter Aortic Valve Implantation (TAVI) using a high-pitch spiral acquisition mode

“…However, according to literature, variations of the annulus size during the cardiac cycle are limited [9,32], especially in patients with severe AS with severe calcifications of the aortic valve and the aortic wall and annulus. A previously published study establishing normative values for ascending aorta measurements found large inter-individual variations in diameters and distances but with limited intra-individual variations during the cardiac cycle [33].…”

Multimodality Imaging of Diseases of the Thoracic Aorta in Adults: From the American Society of Echocardiography and the European Association of Cardiovascular Imaging

“…4 The establishment of normative values and reference ranges, taking into account aging and gender, is of great importance for diagnosis, prognosis, serial monitoring, and determining the optimal timing for surgical intervention. Normal values and proximal aortic diameters have been reported using different imaging techniques, from the pioneer studies based on M-mode and 2D echocardiography 9,10 to more recent studies obtained using CT 7,8,20,[23][24][25] and MRI. 5,26 Despite differences in image acquisition methods, temporal and spatial resolution, and signal-to-noise ratios, CT, MRI, TTE, and transesophageal echocardiography (TEE) have evolved as near equal standards for assessing aortic root size.…”

Remodelling of the aortic root in severe tricuspid aortic stenosis: implications for transcatheter aortic valve implantation

“…Thus, CT allows for an accurate assessment of coronary arteries [15][16][17] and aortic root morphology [18,19].…”