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Feasibility of Aortic Annular Measurements Using Noncontrast-Enhanced Cardiac Computed Tomography in Preprocedural Evaluation of Transcatheter Aortic Valve Replacement: A Comparison With Contrast-Enhanced Computed Tomography

Authors
 Young Joo Suh  ;  Sak Lee  ;  Geu-Ru Hong  ;  Young-Guk Ko  ;  Myeong-Ki Hong  ;  Young Jin Kim 
Citation
 JOURNAL OF COMPUTER ASSISTED TOMOGRAPHY, Vol.46(1) : 50-55, 2022-01 
Journal Title
JOURNAL OF COMPUTER ASSISTED TOMOGRAPHY
ISSN
 0363-8715 
Issue Date
2022-01
MeSH
Aged ; Aged, 80 and over ; Aortic Valve* / diagnostic imaging ; Aortic Valve* / surgery ; Contrast Media ; Feasibility Studies ; Female ; Humans ; Male ; Perioperative Period ; Retrospective Studies ; Tomography, X-Ray Computed / methods* ; Transcatheter Aortic Valve Replacement / methods*
Abstract
Objective: Noncontrast-enhanced (NCE) cross-sectional images other than contrast-enhanced (CE)-computed tomography (CT) may be necessary for annular sizing before transcatheter aortic valve replacement (TAVR), because of the risk of contrast-induced nephropathy. We aimed to investigate the feasibility of aortic annular measurements using NCE-CT in TAVR candidates by comparing them with CE-CT measurements.

Methods: We retrospectively enrolled 46 patients who underwent CT for the purpose of pre-TAVR evaluation (17 men; mean age, 82.3 ± 5.0 years). On CE and NCE examination, measurements of the average diameter and perimeter of aortic annulus were performed by 2 observers, and coronary ostial heights were measured. Differences in annular parameters and coronary ostial heights between NCE and CE examinations were assessed using Bland-Altman analysis and intraclass correlation coefficients (ICCs).

Results: Aortic annulus measurement values were significantly larger in the NCE examinations compared with those in the CE examinations according to both readers (mean differences of 0.8 mm for the average diameter and 2.1 mm for the perimeter according to observer 1, and 1.1 mm for the average diameter and 3.4 mm for the perimeter according to observer 2; ICC, 0.771-0.923). The mean difference between coronary ostial height measurement on NCE and CE examination was 0.6 mm for left coronary ostium (ICC, 0.795) and 0.7 mm for right coronary ostium (ICC, 0.802). No case showed disagreement between NCE and CE examinations for hypothetical valve sizing.

Conclusions: Noncontrast-enhanced cardiac CT examination may be feasible for aortic annular measurements before TAVR and provides comparable measurement values to CE examination.
Full Text
https://journals.lww.com/jcat/Fulltext/2022/01000/Feasibility_of_Aortic_Annular_Measurements_Using.9.aspx
DOI
10.1097/RCT.0000000000001238
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
Yonsei Authors
Ko, Young Guk(고영국) ORCID logo https://orcid.org/0000-0001-7748-5788
Kim, Young Jin(김영진) ORCID logo https://orcid.org/0000-0002-6235-6550
Suh, Young Joo(서영주) ORCID logo https://orcid.org/0000-0002-2078-5832
Lee, Sak(이삭) ORCID logo https://orcid.org/0000-0001-6130-2342
Hong, Geu Ru(홍그루) ORCID logo https://orcid.org/0000-0003-4981-3304
Hong, Myeong Ki(홍명기) ORCID logo https://orcid.org/0000-0002-2090-2031
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/188084
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