Automated MDCT Post-Processing Software for Aortic Annulus Parameters before Surgical Aortic Valve Replacement: Correlation with Operative Details

Background: A comparative study between the automated MDCT post-processing to measure the aortic annulus parame-ters before surgical aortic valve replacement and intra-opera-tive aortic annulus sizing was done. Aim of Study: To compare the accuracy of pre-operative automated Fuji software synapse 3D tools with the surgical de-tails of aortic valve replacement, regarding the aortic annulus parameters and distance between the aortic annulus and the coronary ostia. Patients and Methods: Our study included 168 patients who presented with significant aortic valve disease. Surgical aortic valve replacement was the treatment of choice. The CT images were post-processed using automated Fuji software synapse 3D tools . Intraoperative aortic valve annulus sizing was done. Results: The mean age of our patients was from 28 to 72 years (mean 54.6±7.2 years). There was a statistically signifi-cant positive correlation between aortic calcification grading and AVA by CT examination. There was excellent agreement for annulus effective and mean diameters (ICC: 0.939 & ICC: 0.881 respectively), good agreement for maximum diameter (ICC: 0.751, 95% CI: (0.479-0.850), poor agreement for mini-mum diameter & annulus area. The correlation of left coronary artery ostium height and right coronary artery ostium height was considered acceptable with a p-value of 0.182 and 0.617 respectively. Conclusion: MDCT is used as a complementary method in pre-procedural planning of aortic valve surgery as it is more accurate in the assessment of aortic valve anatomy, calcifica-tion, and aortic annulus sizing. The automated post-processing software tools provide important clinical application in the management of patients undergoing surgical aortic valve re-placement with reliable and reproducible aortic annulus meas-urements, thus reducing the post-procedural complications.