155 Multimodal Assessment of the Aortic Annulus Diameter. Implications for Transcatheter Aortic Valve Implantation

ObjectivesWe sought to compare three modalities of measurements of the aortic annulus, transthoracic (TTE), transesophageal echocardiography (TEE), and multislice computed tomography (MSCT), and to evaluate their potential clinical impact on transcatheter aortic valve implantation (TAVI) strategy.BackgroundTAVI is an alternative to surgery for high-risk patients with severe aortic stenosis (AS). Exact measurement of the aortic annulus is critical for appropriate patient's selection and successful implantation.MethodsAnnulus diameter was measured using TTE, TEE and MSCT in 45 consecutive patients with severe AS, referred for TAVI. TAVI was performed using a balloon expendable valve (Edwards-Sapien). The TAVI strategy (decision to implant and choice of the prosthesis’ size) was based on manufacturer's recommendations.ResultsCorrelations between methods were good but absolute difference between MSCT and TTE (1.22±1.3 mm) or TEE (1.52±1.1 mm) was significantly larger than the absolute difference between TTE and TEE (0.6±0.8 mm, p=0.03 and p