I think the controversy is with the correct lvot dimensions, not with the aortic annulus.if you are imaging the cases for Tavi,then there lot more dimensions to be considered. A good quality TEE gives to the right answer which matches well with CT findinds to decide for the size of the valve to be given
You can find the answer to your question in the paper "Multimodal Assessment of the Aortic Annulus Diameter: Implications for Transcatheter Aortic Valve Implantation" published in the J Am Coll Cardiol 2010; 55 (3): 186-194. The paper supplies both methodological and clinical responses.
Hi Imran, the aortic annulus is a well defined anatomical structure, as opposed to the mitral annulus which is opened posteriorly, which divides the left ventricle from the aorta. Therefore, it is not the left ventricular outflow tract.
Morphologically the sonographer means the following: the localisation of the AV annulus is defined where the AV cusps meet the aortic wall. The measure of the annulus will be done in several planes (parasternal long axis, parasteranl short axis at AV level, apical long axis view = 3 chamber view and 4 chamber view). Parameters to be evaluated should be width (ant.-post. and lat.-sept. direction) as well as circumference, the mean calculated area as well as the mean calculated widthof the annulus.
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