Validation of 3D-reconstructed computed tomography images using OsiriX® software for pre-transcatheter aortic valve implantation aortic annulus sizing.

Gumsheimer, Marlena; Stortecky, Stefan; Gahl, Brigitta; Langhammer, Bettina; Carrel, Thierry; Büllesfeld, Lutz; Huber, Christoph; Most, Henriette (2017). Validation of 3D-reconstructed computed tomography images using OsiriX® software for pre-transcatheter aortic valve implantation aortic annulus sizing. Interactive cardiovascular and thoracic surgery, 25(2), pp. 198-205. Oxford University Press 10.1093/icvts/ivx119

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OBJECTIVES We report validation of OsiriX -an image processing freeware-to measure multi-slice computed tomography-derived annulus diameters for preprocedural transcatheter aortic valve implantation planning. METHODS A total of 137 patients (82 ± 6.5 years, 42.3% male, logistic EuroSCORE 24.1 ± 14.2%) with severe aortic stenosis at high surgical risk underwent transcatheter aortic valve implantation assessment: transoesophageal echocardiography, angiography and multi-slice computed tomography. Retrospectively, 3D multi-slice computed tomography reconstructions were generated using OsiriX and the reliability evaluated regarding inter- and intraobserver variability, intermodality correlation and estimation of the clinical impact on transcatheter aortic valve implantation sizing. RESULTS Reliability of the novel OsiriX software was high with an interobserver mean difference of 0.6 ± 1.4 mm and intraclass correlation of absolute agreement of 0.84 (95% confidence interval 0.74-0.90). The intermodality accuracy between OsiriX measurements and conventional 2D computed tomography reconstructions, transoesophageal echocardiography and angiography revealed significantly larger sizing with OsiriX, with a mean difference to 2D computed tomography of 0.4 ± 2.2 mm, which would have changed valve sizing in 38% of patients. In 28%, a larger size would have been chosen, and this correlated highly with the occurrence of postoperative severe aortic regurgitation ( P  < 0.001). CONCLUSIONS While OsiriX measurements are an accurate and reproducible assessment of the aortic annulus, there are distinct and clinically relevant differences in aortic annulus dimensions between OsiriX measurements and previously standard imaging modalities. Sizing with OsiriX resulted in a larger perimeter compared with conventional 2D imaging. Careful assessment of valve size will take into account multiple imaging modalities.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiovascular Surgery
04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology

UniBE Contributor:

Stortecky, Stefan; Gahl, Brigitta; Langhammer, Bettina; Carrel, Thierry; Büllesfeld, Lutz; Huber, Christoph and Most, Henriette

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1569-9293

Publisher:

Oxford University Press

Language:

English

Submitter:

Daniela Huber

Date Deposited:

29 Nov 2017 08:37

Last Modified:

29 Nov 2017 08:37

Publisher DOI:

10.1093/icvts/ivx119

PubMed ID:

28486661

Uncontrolled Keywords:

3D imaging Aortic annulus dimensions TAVI prosthesis sizing

BORIS DOI:

10.7892/boris.101639

URI:

https://boris.unibe.ch/id/eprint/101639

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