Paul Apfaltrer MD, Abstract Co-Author: Nothing to Disclose

Thomas Henzler MD, Abstract Co-Author: Nothing to Disclose

Mathias Meyer, Abstract Co-Author: Nothing to Disclose

Hashim Jafarov, Abstract Co-Author: Nothing to Disclose

Stefan Oswald Schoenberg MD, PhD, Abstract Co-Author: Nothing to Disclose

Christian Fink MD, Presenter: Nothing to Disclose

Tim Süselbeck, Abstract Co-Author: Speaker, Boston Scientific Corporation Speaker, Eli Lilly and Company Speaker, DAIICHI SANKYO Group Speaker, Medtronic, Inc

Holger Schröfel, Abstract Co-Author: Nothing to Disclose

Gerhard Schymik, Abstract Co-Author: Nothing to Disclose

ECG gated CT angiography (CTA) has been proposed for assessing the dimensions of the aortic annulus (AA) and left ventricular outflow tract (LVOT) for sizing of valve prostheses at transfemoral aortic valve implantation (TAVI). The purpose of this study was to evaluate, whether the reconstruction phase (systolic or diastolic) at CTA affects the valve sizing.

42 patients (mean age 80±8 years, 27 female) scheduled for aortic valve implantation were examined by CTA. The dimensions of the AA and LVOT were measured in systolic and diastolic reconstructions (30% and 70%) using multiplanar reformats orientated along the valvular plane and perpendicular to the LVOT axis. Differences of the maximum and minimum diameter of the AA and LVOT on systolic and diastolic phases were compared. Furthermore, in patients who were already operated (n=28) measurements were compared to the size of the valve used at TAVI.

Dimensions of the AA and LVOT did not significantly differ between systolic and diastolic phases (e.g. maximum diameter: AA 26.8 +/-3 mm vs. 26.7 +/-3 mm and LVOT 27.2+/-3 mm vs. 27.6+/3 mm; p>0.05). Although not significant, there was a trend towards better prediction of the final valve size using the maximum diameter of the AA and LVOT.

The reconstruction phase of CTA does not seem to affect the dimensions of the AA and LVOT. The maximum diameter seems to predict the valve size of TAVI more precisely.

ECG gated CTA allows reliable sizing of valve prostheses at TAVI independent of the reconstruction phase.

Apfaltrer, P, Henzler, T, Meyer, M, Jafarov, H, Schoenberg, S, Fink, C, Süselbeck, T, Schröfel, H, Schymik, G, Sizing of Transfemoral Aortic Valve Prostheses Using ECG-gated CT Angiography: Which Reconstruction Phase Should Be Used?.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11007190.html