Article ; Online: Standardization and validation of neoLVOT assessment using three-dimensional trans-esophageal echocardiography before trans-catheter mitral valve replacement.
Echocardiography (Mount Kisco, N.Y.)
2024 Volume 41, Issue 3, Page(s) e15785
Abstract: Background: Trans-catheter mitral valve replacement (TMVR) procedures had emerged as an alternative solution for patients who are at high risk for mitral valve surgery. Although cardiac computed tomography (CT) remains the standard method for procedural ...
| Abstract | Background: Trans-catheter mitral valve replacement (TMVR) procedures had emerged as an alternative solution for patients who are at high risk for mitral valve surgery. Although cardiac computed tomography (CT) remains the standard method for procedural planning, there is no full agreement on the best systolic phase for quantitation of the neoLVOT. Furthermore, a new three-dimensional trans-esophageal echocardiography (3DTEE) based software was developed to serve as filter and or an alternative for patients who cannot have CT due to any contraindication. Aim: To determine the systolic phase of the cardiac cycle that shows the narrowest NeoLVOT area in order to standardize the way of using these software and then to validate the 3DTEE-based software against the CT-based one as a gold standard, in mitral valve annulus (MA) and NeoLVOT assessment. Methods: A single center, observational, retrospective study. Initially, a sample of 20 patients (age 62 ± 4 years, 70% men) had CT-based analysis at mid-diastole (80%), early-systole (10%), mid-systole (20%), late-systole (30%-40%), in order to detect the best systolic phase at which the neoLVOT area is the narrowest after TMVR. Then, the end systolic phase was standardized for the analysis of 49 patients (age 57 ± 6 years, 60% men), using both the commercially available CT-based software and the newly available 3DTEE-based software (3mensio Structural Heart, Pie Medical Imaging, The Netherlands). The 3DTEE derived parameters were compared with the gold standard CT-based measurements. Results: The neoLVOT area was significantly narrower at end-systole (224 ± 62 mm Conclusions: End-systole is the phase that shows the narrowest neoLVOT and hence should be the standard phase used during the analysis. The 3DTEE based analysis using this new software is reliable compared to the CT-based analysis and can be serve as an alternative analysis tool in patients who cannot have CT for any clinical contraindication or as a screening test and/or filter for all patients before proceeding to a detailed CT scan. |
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| MeSH term(s) | Aged ; Female ; Humans ; Male ; Middle Aged ; Catheters ; Echocardiography, Three-Dimensional/methods ; Echocardiography, Transesophageal/methods ; Heart Valve Prosthesis ; Heart Valve Prosthesis Implantation/methods ; Mitral Valve/diagnostic imaging ; Mitral Valve/surgery ; Reference Standards ; Reproducibility of Results ; Retrospective Studies |
| Language | English |
| Publishing date | 2024-03-01 |
| Publishing country | United States |
| Document type | Journal Article ; Observational Study |
| ZDB-ID | 843645-9 |
| ISSN | 1540-8175 ; 0742-2822 |
| ISSN (online) | 1540-8175 |
| ISSN | 0742-2822 |
| DOI | 10.1111/echo.15785 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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