Imaging in Transcatheter Aortic Valve Replacement (TAVR): Role of the radiologist

Diana E. Litmanovich, Eduard Ghersin, David A. Burke, Jeffrey Popma, Maryam Shahrzad, Alexander A. Bankier

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

Background: Transcatheter aortic valve replacement (TAVR) is a novel technique developed in the last decade to treat severe aortic stenosis in patients who are non-surgical candidates because of multiple comorbidities. Methods: Since the technique is performed using a transvascular approach, pre-procedural assessment of the aortic valve apparatus, ascending aorta and vascular access is of paramount importance for both appropriate patient selection and correct device selection. This assessment is performed by a multi-disciplinary team with radiology being an integral and important part. Results: Among imaging modalities, there is growing scientific evidence supporting the crucial role of MDCT in the assessment of the aortic valve apparatus, suitability of the iliofemoral or alternative pathway, and determination of appropriate coaxial angles. MDCT also plays an important role in post-procedure imaging in the assessment of valve integrity and position. Conclusion: This review outlines the principal aspects of TAVR, the multidisciplinary approach and utilisation of different imaging modalities, as well as a step-by-step approach to MDCT acquisition protocols, reconstruction techniques, pre-procedure measurements and post-procedure assessment. Teaching Points: • TAVR is a new technique to treat severe aortic stenosis in high-risk and nonsurgical candidates. • MDCT assessment of the aortic annulus is important for appropriate patient and device selection. • Multidisciplinary approach is required for patient selection, procedure planning and performance. • MDCT is required for assessment of the aortic root, iliofemoral or alternative vascular pathway.

Original languageEnglish
Pages (from-to)123-145
Number of pages23
JournalInsights into Imaging
Volume5
Issue number1
DOIs
StatePublished - Feb 1 2014

Fingerprint

Patient Selection
Aortic Valve Stenosis
Aortic Valve
Blood Vessels
Equipment and Supplies
Radiology
Aorta
Comorbidity
Teaching
Transcatheter Aortic Valve Replacement
Radiologists

Keywords

  • Aortic annulus
  • ECG-gating
  • MDCT
  • Multiplanar reconstructions
  • TAVR

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Imaging in Transcatheter Aortic Valve Replacement (TAVR) : Role of the radiologist. / Litmanovich, Diana E.; Ghersin, Eduard; Burke, David A.; Popma, Jeffrey; Shahrzad, Maryam; Bankier, Alexander A.

In: Insights into Imaging, Vol. 5, No. 1, 01.02.2014, p. 123-145.

Research output: Contribution to journalArticle

Litmanovich, DE, Ghersin, E, Burke, DA, Popma, J, Shahrzad, M & Bankier, AA 2014, 'Imaging in Transcatheter Aortic Valve Replacement (TAVR): Role of the radiologist', Insights into Imaging, vol. 5, no. 1, pp. 123-145. https://doi.org/10.1007/s13244-013-0301-5
Litmanovich, Diana E. ; Ghersin, Eduard ; Burke, David A. ; Popma, Jeffrey ; Shahrzad, Maryam ; Bankier, Alexander A. / Imaging in Transcatheter Aortic Valve Replacement (TAVR) : Role of the radiologist. In: Insights into Imaging. 2014 ; Vol. 5, No. 1. pp. 123-145.
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