Table 5

Summary of Recommendations for the Sizing and Reporting of the Aortic Valve, Annulus and Outflow Tract

RecommendationGrade of Recommendation
Annulus assessment and planning
While facilitated or semi-automated workflows may be used, the interpreter analyzing the imaging must be able to confirm the accuracy of the generated annular plane and perform manual corrections if required.Strong
Systolic measurements are preferred for measurement and calculation of device sizingStrong
Area and perimeter measurements are preferred for sizing of the aortic annulus over isolated 2 dimensional measurements and should be provided in the reportStrong
Landing zone calcification
Annular and subannular calcification should be qualitatively described regarding morphology and extent as well as relation to the aortic valve cusps.Strong
Valve morphology
Number of cusps should be stated, and if a bicuspid valve is present, its morphology should be classified.Strong
The presence of a median raphe and the absence/presence of calcification of this should be mentionedStrong
The aortic annulus size should be measured and reported in bicuspid aortic valves as for tricuspid aortic valves.Strong
Aortic root measurement
Pre-TAVI/TAVR CT assessment should include coronary height, mean SOV diameter, and STJ height and diameterStrong
Coronary ostial distance from aortic annulus should be measured in a perpendicular fashion from the established annular planeStrong

CT = computed tomography; SOV = sinus of valsalva; STJ = sinotubular junction; TAVI = transcatheter aortic valve implantation; TAVR = transcatheter aortic valve replacement.

  • Based on level of consensus.