Comprehensive imaging evaluation of the aortic valve and root before aortic root surgery: a study comparing MDCT and TEE

TL;DR

This study compares MDCT and TEE for evaluating aortic valves and roots before surgery, finding that MDCT can be a reliable alternative.

Contribution

The study identifies optimal MDCT measurement methods for aortic root surgery assessment compared to TEE.

Findings

Area-derived diameter showed best correlation for annulus diameter measurements.

Circumference-derived diameter was optimal for sinus of Valsalva diameter.

Minimum cross-sectional diameter best agreed with TEE for STJ diameter.

Abstract

To investigate the accuracy and consistency of MDCT and TEE in the preoperative assessment of aortic root surgery.

From January 2021 to September 2022, 118 patients who underwent aortic root surgery were included in this study. All patients underwent high-quality preoperative MDCT and TEE examinations, and the examination results were independently measured and assessed by two senior radiologists or ultrasound specialists. Bland–Altman analysis and Pearson correlation testing were employed to assess the correlation and consistency between MDCT and TEE. These analyses were then compared with actual intraoperative measurement data.

Among all the patients, 73 (61.86%) had tricuspid aortic valve (TAV), and 45 (38.14%) had bicuspid aortic valve (BAV). A comparison between the TEE and MDCT measurements showed that for the annulus diameter, the area-derived diameter had the best correlation and agreement. For the sinus of Valsalva diameter, the circumference-derived diameter was optimal. However, for the STJ diameter, the minimum cross-sectional diameter showed the best agreement with TEE. In contrast, measurements of geometric height showed a weaker correlation and agreement.

Contrast-enhanced MDCT can be a valuable tool for perioperative evaluation in aortic root surgery, with good correlation, consistency, and feasibility when compared to TEE. The choice of MDCT measurement methodology, specifically area-derived and circumference-derived diameter, proved to be more accurate than other methods. Further research is required to enhance the understanding of aortic valve repair and associated imaging techniques.

The online version contains supplementary material available at 10.1186/s12872-024-04031-6.

Figures