Sensitivity and specificity of transesophageal echocardiography for determination of aortic valve morphology

Background Preoperative recognition of the presence of bicuspid aortic valv e can be important in the planning of procedures. Multiplane transesophagea l echocardiography may allow more accurate detection of valvular morphology than does biplane transesophageal echocardiography. Methods and Results The studies of 710 patients who subsequently underwent valvular or aortic surgery were reviewed in a blinded fashion. The inclusio n criteria were adequate short-axis view and operative note confirmation of aortic valve morphology. Six hundred eight patients were submitted to furt her analysis. Four hundred three patients had aortic stenosis as the primar y diagnosis. Three hundred sixty patients had biplane examinations and 248 had multiplane examinations. The sensitivity and specificity of the multipl ane technique in assessing aortic valve morphology (bicuspid vs tricuspid v alve) was 87% and 91%, respectively. The sensitivity and specificity of the biplane technique was 66% and 56%, respectively. Whether valves were calci fied or not did not result in major changes in sensitivity and specificity for either technique. Conclusions Multiplane transesophageal echocardiography provides a more acc urate assessment of preoperative aortic valve morphology than does the bipl ane approach in the majority of patients.