Pre-Procedural Imaging of Aortic Root Orientation and Dimensions Comparison Between X-Ray Angiographic Planar Imaging and 3-Dimensional Multidetector Row Computed Tomography》.pdfVIP

J A C C : C A R D I O V A S C U L A R I N T E R V E N T I O N S V O L . 3 , N O . 1 , 2 0 1 0 © 2 0 1 0 B Y T H E A M E R I C A N C O L L E G E O F C A R D I O L O G Y F O U N D A T I O N I S S N 1 9 3 6 - 8 7 9 8 / 1 0 / $ 3 6 . 0 0 P U B L I S H E D B Y E L S E V I E R I N C . D O I : 1 0 . 1 0 1 6 / j . j c i n . 2 0 0 9 . 1 0 . 0 1 4 Pre-Procedural Imaging of Aortic Root Orientation and Dimensions Comparison Between X-Ray Angiographic Planar Imaging and 3-Dimensional Multidetector Row Computed Tomography Vikram Kurra, MD,*† Samir R. Kapadia, MD,* E. Murat Tuzcu, MD,* Sandra S. Halliburton, PHD,*† Lars Svensson, MD,* Eric E. Roselli, MD,* Paul Schoenhagen, MD*† Cleveland, Ohio Objectives We sought to examine whether contrast-enhanced multidetector row computed tomog- raphy (MDCT) allows prediction of X-ray angiographic planes for the root angiogram in the context of transcatheter aortic valve implantation. Background Understanding of aortic root orientation relative to the body axis is critical for precise positioning of the stent/valve during transcatheter aortic valve implantation. Methods Forty patients with severe aortic stenosis underwent conventional X-ray angiography and contrast-enhanced MDCT of the aortic root. Oblique MDCT images of the aortic root, corresponding to X-ray angiographic left anterior oblique (LA)/right anterior oblique (RAO) projections, were cre- ated. The cranial/caudal angulation was compared between angiographic and reformatted MDCT images. In addition, root diameter measurements were compared. Results The cranial angulation in the LAO X-ray angiograms (mean LAO: 39 8, n 38) and matched MDCT images were not significantly different (cranial: 25 7 vs. 23 8; p 0.214). There was a small but significant difference between the caudal angulation in the RAO angiog