Imaging the Aortic Annulus with Multi-Detector Computed Tomography and 3-Dimensional Transesophageal Echocardiography

Abstract

Degenerative aortic stenosis is the most common cause of valvular heart disease in Western nations. Transcatheter aortic valve replacement (TAVR) is an alternative therapy for inoperable or high-risk patients with symptomatic severe aortic stenosis. Three-dimensional imaging techniques provide multiplanar imaging, allowing precise measurements of the noncircular aortic annulus and complex anatomy of the aortic root. These measurements influence patient eligibility, allow adequate prosthesis sizing, and determine the success of implantation and likelihood of complications. This review compares imaging modalities and addresses their strengths and weaknesses to assess the aortic annulus and other aortic root structures.

Keywords: 3-dimensional transesophageal echocardiography; Aortic annular sizing; Balloon expandable valve; Multidetector computer tomography; Paravalvular aortic regurgitation; Self-expandable valve; Transcatheter aortic valve implantation; Transcatheter aortic valve replacement.