Abstract
Accurate assessment of aortic root geometry is increasingly important in the era of transcatheter aortic valve replacement (TAVR) in symptomatic patients with severe aortic stenosis (AS) and high surgical risk. Although contrast-enhanced multidetector computed tomography (MDCT) has become an integral part of evaluating aortic root morphology in AS patients, not all patients who would be candidates for TAVR can undergo MDCT due to renal impairment and radiation exposure. Except for accurate determination of left ventricular volumes, which has the potential for reliable determination of functional aortic valve area, three-dimensional (3D) transthoracic echocardiography has limited utility due to lower spatial and temporal resolution and large 3D transducer. In contrast, 3D transesophageal echocardiography (3DTEE) provides a superb view of the aortic root in every patient and is another potential modality for the assessment of aortic root geometry. This article will describe the current clinical utility of 3D echocardiography for assessment of the aortic root, and its advantage and limitations compared to other imaging modalities.
