Automated 3-dimensional aortic annular assessment by multidetector computed tomography in transcatheter aortic valve implantation

Yusuke Watanabe, Marie Claude Morice, Erik Bouvier, Tora Leong, Kentaro Hayashida, Thierry Lefèvre, Thomas Hovasse, Mauro Romano, Bernard Chevalier, Patrick Donzeau-Gouge, Arnaud Farge, Bertrand Cormier, Philippe Garot

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Abstract

Objectives This study sought to evaluate the accuracy, reproducibility, and predictive value for post-procedural aortic regurgitation (AR) of an automated multidetector computed tomography (MDCT) post-processing imaging software, 3mensio Valves (version 5.1.sp1, 3mensio Medical Imaging BV, the Netherlands), in the assessment of patients undergoing transcatheter aortic valve implantation (TAVI). Background Accurate pre-operative aortic annulus measurements are crucial for patients undergoing TAVI. Methods One hundred five patients undergoing MDCT screening before TAVI were evaluated. Aortic annular measurement was compared between automated 3mensio Valves software and manual data post-processing software on a dedicated workstation; we analyzed the discrimination value of annulus measurement for post-procedural AR in 44 recipients of a self-expanding valve. Results The automated 3mensio Valves software showed good concordance with manual MDCT measurements as demonstrated by Bland-Altman analysis. The automated software provided equally good reproducibility as manual measurement, especially for measurement of aortic annulus area (intraobserver intraclass correlation coefficients 0.98 vs. 0.97, interobserver 0.98 vs. 0.95). In 44 patients after implantation of a self-expanding valve, the valve diameter/CT-measured geometric mean annulus diameter ratio by automated 3mensio Valves software showed moderate and better discrimination ability in predicting post-procedural AR compared with manual measurement (p = 0.12, area under the curve 0.77, 95% confidence interval: 0.63 to 0.91, area under the curve 0.68, 95% confidence interval: 0.50 to 0.86, respectively). Conclusions The automated 3mensio Valves software demonstrated reliable, reproducible aortic annulus measurement and better predictive value for post-procedural AR, suggesting important clinical implications for pre-operative assessment of patients undergoing TAVI.

Original languageEnglish
Pages (from-to)955-964
Number of pages10
JournalJACC: Cardiovascular Interventions
Volume6
Issue number9
DOIs
Publication statusPublished - 2013 Sep 1

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Keywords

  • annulus measurement
  • multidetector computed tomography
  • transcatheter aortic valve implantation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Watanabe, Y., Morice, M. C., Bouvier, E., Leong, T., Hayashida, K., Lefèvre, T., Hovasse, T., Romano, M., Chevalier, B., Donzeau-Gouge, P., Farge, A., Cormier, B., & Garot, P. (2013). Automated 3-dimensional aortic annular assessment by multidetector computed tomography in transcatheter aortic valve implantation. JACC: Cardiovascular Interventions, 6(9), 955-964. https://doi.org/10.1016/j.jcin.2013.05.008