Aortic valve disease occurs due to calcification deposits on the area of leaflets within the human heart. It is progressive over time where it can affect the mechanism of the heart valve. To avoid the risk of surgery for vulnerable patients especially senior citizens, a new method has been introduced: Transcatheter Aortic Valve Implantation (TAVI), which places a synthetic catheter within the patient's valve. This entails a procedure of aortic annulus sizing, which requires manual measurement of the scanned images acquired from Computed Tomographic (CT) by experts. The step requires intensive efforts, though human error may still eventually lead to false measurement. In this research, image processing techniques are implemented onto cardiac CT images to achieve an automated and accurate measurement of the heart annulus. The image is first put through pre-processing for noise filtration and image enhancement. Then, a marker image is computed using the combination of opening and closing operations where the foreground image is marked as a feature while the background image is set to zero. Marker image is used to control the watershed transformation and also to prevent oversegmentation. This transformation has the advantage of fast computational and oversegmentation problems, which usually appear with the watershed transform can be solved with the introduction of marker image. Finally, the measurement of aortic annulus from the image data is obtained through morphological operations. Results affirm the approach's ability to achieve accurate annulus measurements compared to conventional techniques. � 2018 Author(s).

Aortic stenosis (AS) is a condition where the calcification deposit within the heart leaflets narrows the valve and restricts the blood from flowing through it. This disease is progressive over time where it may affect the mechanism of the heart valve. To alleviate this condition without resorting to surgery, which runs the risk of mortality, a new method of treatment has been introduced: Transcatheter Aortic Valve Implantation (TAVI), in which imagery acquired from real-Time echocardiogram (Echo) are needed to determine the exact size of aortic annulus. However, Echo data often suffers from speckle noise and low pixel resolution, which may result in incorrect sizing of the annulus. Our study therefore aims to perform an automated detection and measurement of aortic annulus size from Echo imagery. Two stages of algorithm are presented-image denoising and object detection. For the removal of speckle noise, Wavelet thresholding technique is applied. It consists of three sequential steps; applying linear discrete wavelet transform, thresholding wavelet coefficients and performing linear inverse wavelet transform. For the next stage of analysis, several morphological operations are used to perform object detection as well as valve sizing. The results showed that the automated system is able to produce more accurate sizing based on ground truth. � 2017 IEEE.