Inter -observer variability in manual measurement of aortic root dimensions in pediatric patients: benefits of using a semi-automated tool

Background Accurate measurement of maximal aortic root dimensions is important for informed decision making on the timing/ nature of aortic valve replacement surgeries in pediatric patients. Currently, the observer manually measures the following metrics to quantify maximum aortic root dimensions: 1) Cusp to Commisure (Cu-Co), and 2) Cusp to Cusp (Cu-Cu) lengths. This introduces significant interobserver variability (IOV), especially if a followup study is performed in a different institution than the previous