P683Is it necessary to perform a TEE prior to implantation of a percutaneous aortic valve?

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Background: It is unknown whether the systematic use of transesophageal echocardiography (TEE) before implantation of percutaneous aortic valve replacement provides additional information to the transthoracic echocardiography (TTE) in assessing the aortic annulus diameter.Purpose: To assess the correlation between measurements of the aortic annulus by TEE and TTE in candidates for transcatheter aortic valve implantation (TAVI).Methods: We analyze the measures of the aortic annulus by TEE and TTE in 75 consecutive patients between 1 week and 2 months before the TAVI. The annulus size was measured in mid-systolic in the parasternal long-axis on ETT, and in the view of the left ventricular (LV) outflow tract between 100° and 120 ° plane rotation on TEE. The measurements were made by two independent experts.Results: 36% were male. The mean age was 81±3 years and mean LVEF was 61%±6%. The mean aortic annulus was 21.44 [20-23] mm on TTE and 21.13 [20-23] on TEE. Both variables showed good agreement with an intraclass correlation coefficient of 0.854 (95% CI 0.768 to 0.908). The Bland-Altman analysis revealed a mean overestimation of the ring diameter of 0.33 mm on ETT (1.5%), with 7% of cases outside the confidence interval of agreement.Conclusion: Regarding the measurement of aortic annulus pre-TAVI, systematic implementation of TEE does not seem to provide additional information to that obtained by TTE. For this reason, the indication of TEE would be recommended only in selected cases.

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