Estimation of the Aortic Valve Annular Size Measured by Pre-Operative Echocardiogram Validated Against Intra Operative Measurement by Standard Valve Sizers in Patient Undergoing Aortic Valve Replacement Open Heart Surgery
DOI:
https://doi.org/10.51985/Keywords:
Aortic Valve, Aortic Valve Stenosis, Diagnostic Accuracy, Echocardiography, Heart Valve Prosthesis Implantation, Intraoperative CareAbstract
Objective: This study was carried out to determine the diagnostic accuracy of transthoracic echocardiography (TTE) for preoperative sizing of the aortic annulus. It was done by comparing its measurements against the reference standard of direct intraoperative valve sizer measurement in patients who were undergoing surgical aortic valve replacement (SAVR).
Methodology: This cross-sectional was conducted at the Department of Cardiac Surgery, Hayatabad Medical Complex, Peshawar. from January 2023 to June 2023. Total 194 consecutive patients who were scheduled for SAVR were enrolled. Preoperative TTE measurements of the aortic annulus were performed in the parasternal long-axis view. The primary outcome was the agreement between TTE and sizer measurements. For this the concordance was defined as a difference of ±1 mm. After data collection the statistical analysis was performed using SPSS version 20.
Results: The mean age of our study population was found to be 66.8 ± 10.5 years, with 63.4% males. The TTE and sizer measurement showed a very strong positive correlation (r = 0.978, p<0.001). However, TTE systematically underestimated the annular diameter with a mean bias of -1.41 mm. The range of Bland-Altman limits of agreement was from -2.31 mm to -0.50 mm. The clinical concordance rate within ±1 mm was 81.4%. while analyzing the subgroups based on gender or valve morphology, they showed no significant differences in measurement discrepancy (p>0.05).
Conclusion: The TTE establishes a very strong correlation with direct intraoperative sizing, but it also exhibits a consistent underestimation bias
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