Comparative reliability of internal and vendor-derived computed tomography angiography (CTA) measurements in pretranscatheter aortic valve replacement (TAVR) assessment.

AIM: Computed tomography angiography (CTA) is essential for preprocedural assessment in transcatheter aortic valve replacement (TAVR), particularly as TAVR becomes the preferred treatment for high-risk patients with severe aortic stenosis. This study compares CTA measurements generated internally with those from an external third-party vendor, focussing on consistency and reliability.

MATERIALS AND

METHODS

We retrospectively analysed 56 patients who underwent standardised pre-TAVR cardiac CTA and CTA of the chest, abdomen, and pelvis. Twenty-five key parameters were measured including cardiac and iliofemoral arterial dimensions. Agreement between internal and external data was assessed using intraclass correlation coefficients (ICCs).

RESULTS

Among 13 cardiac CTA metrics, 10 metrics demonstrated excellent or good-to-excellent agreement (ICCs 0.91-0.98). Of the 12 iliofemoral metrics, 10 metrics demonstrated moderate-to-good agreement (ICCs 0.70-0.85).

CONCLUSION

Cardiac measurements, often obtained at well-defined anatomical landmarks, demonstrated stronger agreement than iliofemoral measurements, which are more prone to variability due to complex vascular anatomy, calcifications, and operator-dependent site selection. Internally generated CTA measurements for TAVR planning show high reliability, especially for cardiac parameters. Although vascular access measurements showed lower agreement, differences were not clinically significant and did not alter patient management. These findings support the use of internal data processing as a safe and effective alternative to external analysis, with potential benefits in workflow efficiency and patient care.