The Journal of Thoracic and Cardiovascular Surgery, Vol 93, 592-596, Copyright © 1987 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
A comparative analysis of left ventriculography and root aortography for estimating aortic annular size
E Imamura, Y Tomizawa, A Hashimoto, H Koyanagi, Y Imai and K Matsumura
This study was undertaken to compare the usefulness of left
ventriculography versus root aortography as a means of assessing the aortic
annular size in 75 patients with a narrow aortic anulus. These patients
were divided into two groups: Group I consisted of 57 patients undergoing
standard aortic valve replacement with a 21 mm prosthesis and Group II
consisted of 18 patients undergoing modified aortic valve replacement with
the aid of an anulus-enlarging procedure or an apico- aortic conduit. In
Group I, left ventriculography gave 23.2 +/- 1.8 mm (mean +/- standard
deviation), whereas the aortography method showed 22.4 +/- 2.7 mm (p less
than 0.05). Those values of 20 mm or less were regarded as imperfect
measurements; inaccurate results were more frequent in the aortography
method (16 cases; 28%) than in the left ventriculography method (only two
cases; 3.5%), with significant difference (p less than 0.025%). In Group
II, there was no significant difference in respective values determined by
the two different methods; 18.7 +/- 3.0 mm, with a range from 13 to 23 mm
in the left ventriculography method, and 19.9 +/- 3.1 mm, with a range from
14 to 24 mm, in the aortography method (p greater than 0.2). Imperfect
measurement by the aortography method tended to occur when the cusp base
was severely deformed. The results indicated that left ventriculography was
more reliable than root aortography for estimating the size of the aortic
anulus.
