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Updated: Jul 3, 2026
09:57
Four-Dimensional Computed Tomography-Guided Valve Sizing for Transcatheter Pulmonary Valve Replacement
Published on: January 20, 2022
One Anatomy, Multiple Valve Choices: Interobserver Agreement in Selecting Transcatheter Pulmonary Valve
Camilo E Pérez-Cualtán1,2, Jaime Cabrales3, Francisco Garay4
1Biomedical Engineering Department, Universidad de los Andes, Bogotá, Colombia.
Summary
Interobserver agreement for transcatheter pulmonary valve replacement (TPVR) device selection is fair to moderate in adults and limited in children. This variability underscores the need for diverse valve options to suit different patient anatomies and contexts.
Area of Science:
- Cardiology
- Medical Imaging
- Surgical Planning
Background:
- Transcatheter pulmonary valve replacement (TPVR) necessitates precise device selection, type, size, and positioning.
- Anatomical variations can complicate procedural planning for TPVR.
Purpose of the Study:
- To assess interobserver agreement (IOA) in TPVR device selection using 3D patient-specific anatomies.
- To establish a framework for evaluating agreement in TPVR device selection.
Main Methods:
- Six experts evaluated valve type (self-expanding, balloon-expandable, surgical approach), size, and position for 60 3D cardiac MRIs.
- Agreement was measured using Cohen's and Fleiss' Kappa coefficients.
Main Results:
- Interobserver agreement was fair to moderate in adults and slight to fair in pediatric cases.
- Self-expanding valves were favored for regular, curved anatomies; surgical approaches for extreme sizes.
- Perfect agreement was rare, observed in only eight cases.
Conclusions:
- TPVR device selection shows limited agreement in pediatrics but moderate agreement in adults.
- Observer variability highlights the need for equitable access to various TPVR solutions for diverse anatomies and patient groups.
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