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 language | English |
|---|---|
| Pages (from-to) | 123-145 |
| Number of pages | 23 |
| Journal | Insights into Imaging |
| Volume | 5 |
| Issue number | 1 |
| DOIs | |
| State | Published - Feb 1 2014 |
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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 journal › Article
}
TY - JOUR
T1 - Imaging in Transcatheter Aortic Valve Replacement (TAVR)
T2 - Role of the radiologist
AU - Litmanovich, Diana E.
AU - Ghersin, Eduard
AU - Burke, David A.
AU - Popma, Jeffrey
AU - Shahrzad, Maryam
AU - Bankier, Alexander A.
PY - 2014/2/1
Y1 - 2014/2/1
N2 - 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.
AB - 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.
KW - Aortic annulus
KW - ECG-gating
KW - MDCT
KW - Multiplanar reconstructions
KW - TAVR
UR - http://www.scopus.com/inward/record.url?scp=84897769494&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84897769494&partnerID=8YFLogxK
U2 - 10.1007/s13244-013-0301-5
DO - 10.1007/s13244-013-0301-5
M3 - Article
AN - SCOPUS:84897769494
VL - 5
SP - 123
EP - 145
JO - Insights into Imaging
JF - Insights into Imaging
SN - 1869-4101
IS - 1
ER -