Is echocardiography reliable in evaluating the ascending aorta compared to computed tomography in patients with bicuspid aortic valve?

1441, poster, cat: 58

IS ECHOCARDIOGRAPHY RELIABLE IN EVALUATING THE ASCENDING AORTA COMPARED TO COMPUTED TOMOGRAPHY IN PATIENTS WITH BICUSPID AORTIC VALVE?

A. Raizada, M.Q. Najib, J. Ganji, M. Kumar, H.P. Chaliki

Mayo Clinic, Scottsdale, AZ, USA
Background: American College of Cardiology / American Heart Association guidelines recommend surgery in patients with bicuspid aortic valve (BAV) and dilated ascending aorta (> 5 cm). It is unclear whether transthoracic echocardiography (TTE) itself is adequate in evaluating the ascending aorta in these patients or additional computed tomography (CT) is needed.

Methods: Using our echocardiography laboratory database from 2004 to 2011, we included a total of 29 patients with BAV (age 58±12 yrs; males 66%) who had both TTE and CT. Time between the imaging modalities was 22 ± 50 days(mean ± SD). The results showed excellent correlation between maximum ascending aortic diameter measured by TTE and CT (r =0.91; p<0.0001) (Figure) with good limits of agreement (0.07 cm ± 0.53 cm; mean±1.96 SD). However, in 7% (2% to 22%; 95% CI) of patients, CT measurement exceeded TTE measurement by ≥ 0.5 cm.

Conclusions: 1) TTE and CT scans have good limits of agreement for the assessment of ascending aortic size in patients with BAV; 2) In a small number of patients, however, aortic size measured by CT scan exceeded the TTE measurement by ≥0.5 cm, which could significantly change patient management. Larger studies are needed to confirm our findings and understand the strengths and limitations of each imaging modality.