1. Date of download: 6/29/2016 Copyright © The American College of Cardiology. All rights reserved. From: Multimodality Imaging in Transcatheter Aortic Valve Implantation and Post-Procedural Aortic Regurgitation: Comparison Among Cardiovascular Magnetic Resonance, Cardiac Computed Tomography, and Echocardiography J Am Coll Cardiol. 2011;58(21):2165-2173. doi:10.1016/j.jacc.2011.09.010 Transthoracic Echocardiography of the AV, Aortic Root, and Ascending Aorta The aortic annulus diameter measured in peak systole between the hinge points of the aortic valve (AV) leaflets (inner edge to inner edge) in a zoomed parasternal long-axis view (A). (B) Measurements of the sinuses of Valsalva (†), sinotubular junction (‡), and proximal ascending aorta 1 cm above the sinotubular junction (§) were made at end-diastole and also in the parasternal long-axis view perpendicular to the long axis of the vessel (* denotes diastolic measurement of the aortic annulus diameter; this measure is not used). (C and D) The 3-chamber view from which Doppler measurements of velocity were acquired for determination of AV stenosis severity. Figure Legend:

2. Date of download: 6/29/2016 Copyright © The American College of Cardiology. All rights reserved. From: Multimodality Imaging in Transcatheter Aortic Valve Implantation and Post-Procedural Aortic Regurgitation: Comparison Among Cardiovascular Magnetic Resonance, Cardiac Computed Tomography, and Echocardiography J Am Coll Cardiol. 2011;58(21):2165-2173. doi:10.1016/j.jacc.2011.09.010 CCT of the Aortic Root and Ascending Aorta Cardiac computed tomography (CCT) images of the patient in Figure 1 demonstrating measurement of the sinotubular junction (*) and aortic annulus (†) in oblique-sagittal (A) and oblique-coronal (B) planes. Three cusp commissure measurements (arrows) of the aortic sinuses were made from a short-axis image of the aortic root (C). The ascending aorta dimensions (arrows) were measured from a transaxial image at the level of the right pulmonary artery (D). (A and B) ‡denotes left ventricular outflow tract measures (not compared in this study). Figure Legend:

3. Date of download: 6/29/2016 Copyright © The American College of Cardiology. All rights reserved. From: Multimodality Imaging in Transcatheter Aortic Valve Implantation and Post-Procedural Aortic Regurgitation: Comparison Among Cardiovascular Magnetic Resonance, Cardiac Computed Tomography, and Echocardiography J Am Coll Cardiol. 2011;58(21):2165-2173. doi:10.1016/j.jacc.2011.09.010 CMR Imaging of the Aortic Root and Ascending Aorta Cardiovascular magnetic resonance (CMR) images demonstrating measurement of the sinotubular junction (*) and aortic annulus (†) in oblique-sagittal (A) and oblique-coronal (B) planes. Three cusp commissure measurements (arrows) of the aortic sinuses were made from a short-axis cine image of the aortic root (C). The internal ascending aorta dimensions (arrows) were measured from a transaxial half-Fourier acquisition single-shot turbo spin-echo image at the level of the right pulmonary artery (D). Figure Legend:

4. Date of download: 6/29/2016 Copyright © The American College of Cardiology. All rights reserved. From: Multimodality Imaging in Transcatheter Aortic Valve Implantation and Post-Procedural Aortic Regurgitation: Comparison Among Cardiovascular Magnetic Resonance, Cardiac Computed Tomography, and Echocardiography J Am Coll Cardiol. 2011;58(21):2165-2173. doi:10.1016/j.jacc.2011.09.010 Bland-Altman Plots Comparing CMR- and CCT-Derived AV Annulus Measurements Bland-Altman plots demonstrating close agreement between cardiovascular magnetic resonance (CMR)– and cardiac computed tomography (CCT)–derived aortic valve (AV) annulus diameters. The largest annulus diameter (A), smallest annulus diameter (B), and average annulus diameter (C) show similar agreement. Upper and lower dotted lines denote the 95% limits of agreement; the middle dotted line is the bias. Figure Legend:

5. Date of download: 6/29/2016 Copyright © The American College of Cardiology. All rights reserved. From: Multimodality Imaging in Transcatheter Aortic Valve Implantation and Post-Procedural Aortic Regurgitation: Comparison Among Cardiovascular Magnetic Resonance, Cardiac Computed Tomography, and Echocardiography J Am Coll Cardiol. 2011;58(21):2165-2173. doi:10.1016/j.jacc.2011.09.010 Bland-Altman Plots Comparing the Largest CMR-, CCT-, and TTE-Derived AV Annulus Measurements Bland-Altman plots demonstrating closer agreement and lower bias for cardiovascular magnetic resonance (CMR)– and cardiac computed tomography (CCT)–derived aortic valve (AV) annulus diameters (A) compared with CMR–transthoracic echocardiography (TTE) (B) and CMR-CCT (C). Upper and lower dotted lines are the 95% limits of agreement; the middle dotted line is the bias. Figure Legend:

6. Date of download: 6/29/2016 Copyright © The American College of Cardiology. All rights reserved. From: Multimodality Imaging in Transcatheter Aortic Valve Implantation and Post-Procedural Aortic Regurgitation: Comparison Among Cardiovascular Magnetic Resonance, Cardiac Computed Tomography, and Echocardiography J Am Coll Cardiol. 2011;58(21):2165-2173. doi:10.1016/j.jacc.2011.09.010 Comparison of Bias Among Imaging Modalities Comparison of the mean bias among CMR, CCT, and TTE demonstrating that TTE underestimates the maximum AV annulus diameter compared with both CMR and CCT. *p < 0.0001 compared with CMR-TTE and CCT-TTE; analysis of variance with Bonferroni correction; error bars represent SD. Abbreviations as in Figure 5. Figure Legend: