Abstract
Objective: To describe aortic valve and root anatomy on multidetector computed tomography (MDCT) and analyze its association with transcatheter heart valve size and platform selection. Methods: This single-center retrospective observational study included 76 patients with severe aortic stenosis undergoing TAVI. Preprocedural MDCT measurements were compared by valve morphology. Associations with prosthesis size were assessed using Spearman correlation, and valve platform using two-sided Fisher’s exact test. Results: Bicuspid aortic valve morphology was present in 46/76 patients (60.5%). Compared with tricuspid valves, bicuspid valves had larger mean annular diameter, annular area, sinus of Valsalva, sinotubular junction height, left coronary height, and ascending aortic diameter (all p<0.05). Prosthesis size correlated strongly with mean annular diameter (rs=0.870), annular perimeter (rs=0.885), and annular area (rs=0.877); all p<0.001. Balloon-expandable valves were used in 95.7% of bicuspid and 76.7% of tricuspid cases (OR=6.70; p=0.025). Conclusion: MDCT annular measurements were closely associated with selected prosthesis size, while valve morphology was associated with valve platform selection in univariable analysis.
