• Keigo Ebuchi, Kenji Yoshitani, Eiki Kanemaru, Tasuku Fujii, Akito Tsukinaga, Yusuke Shimahara, and Yoshiniko Ohnishi.
• Department of Anesthesiology, National Cerebral and Cardiovascular Center, Osaka, Japan.
• J. Cardiothorac. Vasc. Anesth. 2019 Sep 1; 33 (9): 2387-2393.

ObjectivesSizing of the aortic valve is crucial for transcatheter aortic valve replacement (TAVR). Multidetector computed tomography (MDCT) is used for sizing. Recently, three-dimensional transesophageal echocardiography (3DTEE) has enabled accurate measurement of the aortic annulus area and diameter in cases that are difficult to measure. The authors compared measurements of aortic annulus areas and diameters acquired by MDCT and 3DTEE.DesignRetrospective observational study.SettingSingle national center.ParticipantsSixty-eight patients who underwent TAVR replacement between September 2015 and March 2017.InterventionsNone.Measurements And Main ResultsThe authors extracted and compared preoperative measurements of the aortic annulus area, as well as the long- and short-axis diameter, measured by MDCT and 3DTEE. There was no significant difference in the aortic annulus area (409 ± 74 v 414 ± 70 mm2, p = 0.15) or short-axis diameter (20.4 ± 2.0 v 20.6 ± 1.9 mm, p = 0.103) between 3DTEE and MDCT, but the long-axis diameter differed significantly (25.0 ± 2.4 v 25.8 ± 2.0 mm, p < 0.001), respectively. Prosthesis sizes based on 3DTEE and MDCT were the same, except in 3 patients who could not stay still during MDCT measurement; in those cases, prosthesis sizes based on 3DTEE were adopted.ConclusionsMeasurements of the aortic annulus area and diameter in TAVR were similar between 3DTEE and MDCT. Patients who have difficulty remaining still during MDCT measurement because of dementia should have their prostheses sized based on 3DTEE measurements.Copyright © 2019 Elsevier Inc. All rights reserved.

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