Non-invasive and invasive evaluation of aortic valve area in 100 patients with severe aortic valve stenosis: Comparison of cardiac computed tomography with ECHO (transesophageal/transthoracic) and catheter examination

Abstract

Our data suggest the feasibility of cardiac MDCT to evaluate the correct AVA regardless of rhythm, heart rate, and sex. The planimetric concept to determine the AVA with CT displaces the "gold-standard" CE with respect to elucidating the potencies for complications, i.e. cerebral stroke. Regardless of CT's accessing of AVA measurement the TTE examination should remain the primary method of screening for aortic valve pathologies.

Difference in Aortic Valve Area Measured With Cardiac CT and Transthoracic Echocardiography

“…However, the CCT measurement of LVOT eccentricity was not associated with difference between AVACCT and AVATTE. Interestingly, AVACCT was not correlated with AVATTE in group with LVOT eccentricity ≥ 0.78. equation-derived AVATTE was significantly smaller than planimetry-derived AVACCT, mainly due to the flow contraction phenomenon observed at the aortic valve [9][10][11][12][13][14][15]. In our study, 24% (n=31) of patients would be reclassified to moderate AS (n=28) or mild AS (n=1) or no AS (n=2) by AVACCT.…”

“…The anatomical AVA or AVACCT is larger than AVATTE. Several factors such as aortic valve calcification and LVOT morphology can affect AVA or AVACCT [12][13][14][15].…”

Comparison of modern risk scores in predicting operative mortality for patients undergoing aortic valve replacement for aortic stenosis

“…A shortcoming of the currently available risk scores is that there are several important risk factors that are not included in the risk calculation, such as severe calcification of the aorta, a history of chest radiation, liver dysfunction, cognitive impairment, nutrition level, anemia, frailty, B-type natriuretic peptide, aortic valve area, and low-flow low-gradient (LF-LG) severe AS [17][18][19][20][21][22]. Among these risk variables, frailty and LF-LG severe AS are particularly important since they are often seen recently in patients with AS.…”

Aortic dimensions by multi-detector computed tomography vs. echocardiography

“…Much interest has lately risen in comparing aortic annular dimensions obtained by MDCT vs. ECHO because of the implementation of the transcatheter aortic valve implantation technique which requires accurate determinations of the aortic annular diameter. These studies were limited to comparing measurements derived from both modalities at only the ANN location as performed by one method only [7][8][9][10][11]. The general conclusion is that there is a good correlation between both modalities at that specific location.…”