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3D transoesophageal echocardiography in the TAVI sizing arena: should we do it and how do we do it?

Echo Research & Practice volume 4, pages R21–R32 (2017)Cite this article

Abstract

Transcatheter aortic valve implantation (TAVI) was initially proven as an alternative to valve replacement therapy in those beyond established risk thresholds for conventional surgery. With time the technique has been methodically refined and offered to a progressively lower risk cohort, and with this evolution has come that of the significant imaging requirements of valve implantation. This review discusses the role of transoesophageal echocardiography (TOE) in the current TAVI arena, aligning it with that of cardiac computed tomography, and outlining how TOE can be used most effectively both prior to and during TAVI in order to optimise outcomes.

References

  1. Ciobotaru V, Maupas E, Dürrleman N, Boulenc J-M, Borton A, Pujadas-Berthault P, Rioux P, Maubon A 2016 Predictive value for paravalvular regurgitation of 3-dimensional anatomic aortic annulus shape assessed by multidetector computed tomography post-transcatheter aortic valve replacement. European Heart Journal: Cardiovascular Imaging 17 85–95. (doi:10.1093/ehjci/jev128)

    PubMed  Google Scholar 

  2. Kasel AM, Cassese S, Bleiziffer S, Amaki M, Hahn RT, Kastrati A, Sengupta PP 2013 Standardized imaging for aortic annular sizing: implications for transcatheter valve selection. JACC: Cardiovascular Imaging 6 249–262. (doi:10.1016/j. cmg.2012.12.005)

    PubMed  Google Scholar 

  3. Mehrotra P, Flynn AW, Jansen K, Tan TC, Mak G, Julien HM, Zeng X, Picard MH, Passeri JJ, Hung J 2015 Differential left ventricular outflow tract remodeling and dynamics in aortic stenosis. Journal of the American Society of Echocardiography 28 1259–1266. (doi:10.1016/j.echo.2015.07.018)

    Article  Google Scholar 

  4. Kenny C, Monaghan M 2015 How to assess aortic annular size before transcatheter aortic valve implantation (TAVI): the role of echocardiography compared with other imaging modalities. Heart 101 727–736. (doi:10.1136/heartjnl-2013-304689)

    Article  Google Scholar 

  5. Ng ACT, Delgado V, van der Kley F, Shanks M, van de Veire NRL, Bertini M, Nucifora G, van Bommel RJ, Tops LF, de Weger A etal 2010 Comparison of aortic root dimensions and geometries before and after transcatheter aortic valve implantation by 2- and 3-dimensional transesophageal echocardiography and multislice computed tomography. Circulation: Cardiovascular Imaging 3 94–102. (doi:10.1161/circimaging.109.885152)

    Google Scholar 

  6. Schultz CJ, Weustink A, Piazza N, Otten A, Mollet N, Krestin G, van Geuns RJ, de Feyter P, Serruys PW, de Jaegere P 2009 Geometry and degree of apposition of the CoreValve ReValving system with multislice computed tomography after implantation in patients with aortic stenosis. Journal of the American College of Cardiology 54 911–918. (doi:10.1016/j.jacc.2009.04.075)

    Article  Google Scholar 

  7. Kim W-K, Meyer A, Möllmann H, Rolf A, Möllmann S, Blumenstein J, Van Linden A, Hamm CW, Walther T, Kempfert J 2016 Cyclic changes in area- and perimeter-derived effective dimensions of the aortic annulus measured with multislice computed tomography and comparison with metric intraoperative sizing. Clinical Research in Cardiology 105 622–629. (doi:10.1007/s00392-016-0971-3)

    Article  Google Scholar 

  8. Khalique OK, Kodali SK, Paradis J-M, Nazif TM, Williams MR, Einstein AJ, Pearson GD, Harjai K, Grubb K, George I etal 2014 Aortic annular sizing using a novel 3-dimensional echocardiographic method: use and comparison with cardiac computed tomography. Circulation: Cardiovascular Imaging 7 155–163. (doi:10.1161/circimaging.113.001153)

    Google Scholar 

  9. Hamdan A, Guetta V, Konen E, Goitein O, Segev A, Raanani E, Spiegelstein D, Hay I, Di Segni E, Eldar M etal 2012 Deformation dynamics and mechanical properties of the aortic annulus by 4-dimensional computed tomography: insights into the functional anatomy of the aortic valve complex and implications for transcatheter aortic valve therapy. Journal of the American College of Cardiology 59 119–127. (doi:10.1016/j.jacc.2011.09.045)

    Article  Google Scholar 

  10. Smith LA, Dworakowski R, Bhan A, Delithanasis I, Hancock J, MacCarthy PA, Wendler O, Thomas MR, Monaghan MJ 2013 Real-time three-dimensional transesophageal echocardiography adds value to transcatheter aortic valve implantation. Journal of the American Society of Echocardiography 26 359–369. (doi:10.1016/j.echo.2013.01.014)

    Article  Google Scholar 

  11. Blanke P, Willson AB, Webb JG, Achenbach S, Piazza N, Min JK, Pache G, Leipsic J 2014 Oversizing in transcatheter aortic valve replacement, a commonly used term but a poorly understood one: dependency on definition and geometrical measurements. Journal of Cardiovascular Computed Tomography 8 67–76. (doi:10.1016/j.jcct.2013.12.020)

    Article  Google Scholar 

  12. Mihara H, Shibayama K, Berdejo J, Harada K, Itabashi Y, Siegel RJ, Kashif M, Jilaihawi H, Makkar RR, Shiota T 2015 Impact of device landing zone calcification on paravalvular regurgitation after transcatheter aortic valve replacement: a real-time three-dimensional transesophageal echocardiographic study. Journal of the American Society of Echocardiography 28 404–414. (doi:10.1016/j.echo.2014.11.013)

    Article  Google Scholar 

  13. Willson AB, Webb JG, LaBounty TM, Achenbach S, Moss R, Wheeler M, Thompson C, Min JK, Gurvitch R, Norgaard BL etal 2012 3-Dimensional aortic annular assessment by multidetector computed tomography predicts moderate or severe paravalvular regurgitation after transcatheter aortic valve replacement: a multicenter retrospective analysis. Journal of the American College of Cardiology 59 1287–1294. (doi:10.1016/j.jacc.2011.12.015)

    Article  Google Scholar 

  14. Popma JJ, Gleason TG, Yakubov SJ, Harrison JK, Forrest JK, Maini B, Ruiz CE, Pinto DS, Costa M, Resar J etal 2016 Relationship of annular sizing using multidetector computed tomographic imaging and clinical outcomes after self-expanding CoreValve transcatheter aortic valve replacement. Circulation: Cardiovascular Interventions 9.e003282. (doi:10.1161/circinterventions.115.003282)

    Google Scholar 

  15. Hahn RT, Gillam LD, Little SH 2015 Echocardiographic imaging of procedural complications during self-expandable transcatheter aortic valve replacement. JACC: Cardiovascular Imaging 8 319–336. (doi:10.1016/j. cmg.2015.01.001)

    PubMed  Google Scholar 

  16. Ludman PF, Moat N, de Belder MA, Blackman DJ, Duncan A, Banya W, MacCarthy PA, Cunningham D, Wendler O, Marlee D etal 2015 Transcatheter aortic valve implantation in the UK: temporal trends, predictors of outcome and 6 year follow up: a report from the UK TAVI registry 2007 to 2012. Circulation 131 1181–1190. (doi:10.1161/circulationaha.114.013947)

    Article  Google Scholar 

  17. Jochheim D, Schneider VS, Schwarz F, Kupatt C, Lange P, Reiser M, Massberg S, Gutiérrez-Chico JL, Mehilli J, Becker HC 2014 Contrast-induced acute kidney injury after computed tomography prior to transcatheter aortic valve implantation. Clinical Radiology 69 1034–1038. (doi:10.1016/j.crad.2014.05.106)

    Article  CAS  Google Scholar 

  18. Cernigliaro JG, Haley WE, Adolphson DP, Jepperson MA, Crook JE, Thomas CS, Parker AS 2016 Contrast-induced nephropathy in outpatients with preexisting renal impairment: a comparison between intravenous iohexol and iodixanol. Clinical Imaging 40 902–906. (doi:10.1016/j.clinimag.2016.04.008)

    Article  Google Scholar 

  19. Achenbach S, Delgado V, Hausleiter J, Schoenhagen P, Min JK, Leipsic JA 2012 SCCT expert consensus document on computed tomography imaging before transcatheter aortic valve implantation (TAVI)/transcatheter aortic valve replacement (TAVR). Journal of Cardiovascular Computed Tomography 6 366–380. (doi:10.1016/j.jcct.2012.11.002)

    Article  Google Scholar 

  20. Leipsic J, Gurvitch R, LaBounty TM, Min JK, Wood D, Johnson M, Ajlan AM, Wijesinghe N, Webb J G 2011 Multidetector computed tomography in transcatheter aortic valve implantation. JACC: Cardiovascular Imaging 4 416–429. (doi:10.1016/j.cmg.2011.01.014)

    PubMed  Google Scholar 

  21. Kiramijyan S, Magalhaes MA, Koifman E, Didier R, Escarcega RO, Minha S, Baker NC, Negi SI, Torguson R, Gai J etal 2016 Impact of baseline mitral regurgitation on short- and long-term outcomes following transcatheter aortic valve replacement. American Heart Journal 178 19–27. (doi:10.1016/j.ahj.2016.03.020)

    Article  Google Scholar 

  22. Cortés C, Amat-Santos IJ, Nombela-Franco L, Muñoz-Garcia AJ, Gutiérrez-Ibanes E, De La Torre Hernandez JM, Córdoba-Soriano JG, Jimenez-Quevedo P, Hernández-García JM, Gonzalez-Mansilla A etal 2016 Mitral regurgitation after transcatheter aortic valve replacement: prognosis, imaging predictors, and potential management. JACC: Cardiovascular Interventions 9 1603–1614. (doi:10.1016/j.jcin.2016.05.025)

    PubMed  Google Scholar 

  23. Hahn RT, Abraham T, Adams MS, Bruce CJ, Glas KE, Lang RM, Reeves ST, Shanewise JS, Siu SC, Stewart W etal 2013 Guidelines for performing a comprehensive transesophageal echocardiographic examination: recommendations from the American Society of Echocardiography and the Society of Cardiovascular Anesthesiologists. Journal of the American Society of Echocardiography 26 921–964. (doi:10.1016/j.echo.2013.07.009)

    Article  Google Scholar 

  24. Zamorano JL, Badano LP, Bruce C, Chan K-L, Gonçalves A, Hahn RT, Keane MG, La Canna G, Monaghan MJ, Nihoyannopoulos P etal 2011 EAE/ASE recommendations for the use of echocardiography in new transcatheter interventions for valvular heart disease. European Heart Journal 32 2189–2214. (doi:10.1093/eurheartj/ehr259)

    Article  Google Scholar 

  25. Tsang W, Bateman MG, Weinert L, Pellegrini G, Mor-Avi V, Sugeng L, Yeung H, Patel AR, Hill AJ, Iaizzo PA etal 2012 Accuracy of aortic annular measurements obtained from three-dimensional echocardiography, CT and MRI: human in vitro and in vivo studies. Heart 98 1146–1152. (doi:10.1136/heartjnl-2012-302074)

    Article  Google Scholar 

  26. Husser O, Holzamer A, Resch M, Endemann DH, Nunez J, Bodi V, Schmid C, Riegger GA, Gössmann H, Hamer O etal 2013 Prosthesis sizing for transcatheter aortic valve implantation–comparison of three dimensional transesophageal echocardiography with multislice computed tomography. International Journal of Cardiology 168 3431–3438. (doi:10.1016/j.ijcard.2013.04.182)

    Article  Google Scholar 

  27. Wang H, Hanna JM, Ganapathi A, Keenan JE, Hurwitz LM, Vavalle JP, Kiefer TL, Wang A, Harrison JK, Hughes GC 2015 Comparison of aortic annulus size by transesophageal echocardiography and computed tomography angiography with direct surgical measurement. American Journal of Cardiology 115 1568–1573. (doi:10.1016/j.amjcard.2015.02.060)

    Article  Google Scholar 

  28. Stortecky S, Heg D, Gloekler S, Wenaweser P, Windecker S, Buellesfeld L 2014 Accuracy and reproducibility of aortic annulus sizing using a dedicated three-dimensional computed tomography reconstruction tool in patients evaluated for transcatheter aortic valve replacement. EuroIntervention 10 339–346. (doi:10.4244/eijv10i3a59)

    Article  Google Scholar 

  29. Faletti R, Gatti M, Salizzoni S, Bergamasco L, Bonamini R, Garabello D, Marra WG, La Torre M, Morello M, Veglia S etal 2016 Cardiovascular magnetic resonance as a reliable alternative to cardiovascular computed tomography and transesophageal echocardiography for aortic annulus valve sizing. International Journal of Cardiovascular Imaging 32 1255–1263. (doi:10.1007/s10554-016-0899-8)

    Article  Google Scholar 

  30. Rendon A, Hamid T, Kanaganayagam G, Karunaratne D, Mahadevan VS 2016 Annular sizing using real-time three-dimensional intracardiac echocardiography-guided trans-catheter aortic valve replacement. Open Heart 3 e000316. (doi:10.1136/openhrt-2015-000316)

    Article  Google Scholar 

  31. Gripari P, Ewe SH, Fusini L, Muratori M, Ng ACT, Cefalù C, Delgado V, Schalij MJ, Bax JJ, Marsan NA etal 2012 Intraoperative 2D and 3D transoesophageal echocardiographic predictors of aortic regurgitation after transcatheter aortic valve implantation. Heart 98 1229–1236. (doi:10.1136/heartjnl-2012-301998)

    Article  Google Scholar 

  32. Buzzatti N, Maisano F, Latib A, Cioni M, Taramasso M, Mussardo M, Colombo A, Alfieri O 2013 Computed tomography-based evaluation of aortic annulus, prosthesis size and impact on early residual aortic regurgitation after transcatheter aortic valve implantation. European Journal of Cardio-Thoracic Surgery 43 43–51. (doi:10.1093/ejcts/ezs155)

    Article  Google Scholar 

  33. García-Martín A, Lázaro-Rivera C, Fernández-Golfín C, Salido-Tahoces L, Moya-Mur J-L, Jiménez-Nacher J-J, Casas-Rojo E, Aquila I, González-Gómez A, Hernández-Antolín R etal 2016 Accuracy and reproducibility of novel echocardiographic three-dimensional automated software for the assessment of the aortic root in candidates for thanscatheter aortic valve replacement. European Heart Journal: Cardiovascular Imaging 17 772–778. (doi:10.1093/ehjci/jev204)

    PubMed  Google Scholar 

  34. Schultz CJ, Rodriguez-Olivares R, Bosmans J, Lefèvre T, De Santis G, Bruining N, Collas V, Dezutter T, Bosmans B, Rahhab Z etal Patient-specific image-based computer simulation for the prediction of valve morphology and calcium displacement after TAVI with the Medtronic CoreValve and the Edwards SAPIEN valve. EuroIntervention 11 1044-1052. (doi:10.4244/eijv11i9a212)

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Authors and Affiliations

  1. Kings College Hospital, London, UK

    Caroline Bleakley MD MRCP, Mehdi Eskandari MD FRACP & Mark Monaghan PhD FRCP(Hon) FACC FESC

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  1. Caroline Bleakley MD MRCP
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  2. Mehdi Eskandari MD FRACP
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Correspondence to Mark Monaghan PhD FRCP(Hon) FACC FESC.

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Bleakley, C., Eskandari, M. & Monaghan, M. 3D transoesophageal echocardiography in the TAVI sizing arena: should we do it and how do we do it?. Echo Res Pract 4, R21–R32 (2017). https://doiorg.publicaciones.saludcastillayleon.es/10.1530/ERP-16-0041

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  • DOI: https://doiorg.publicaciones.saludcastillayleon.es/10.1530/ERP-16-0041

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Echo Research & Practice

ISSN: 2055-0464

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