Transcatheter aortic valve replacement (TAVR) is an emerging minimally invasive procedure in patients with severe aortic valve stenosis who are considered at high risk for surgical treatment .
A comprehensive pre-procedural diagnostic workup is essential for careful patient selection and proper TAVR planning .
In this context,
computed tomography (CT) is increasingly gaining importance as it provides both information about aortic annular sizing for prosthesis deployment and assessment...
Methods and Materials
Patients Between January 2012 and January 2013,
37 patients who were considered for the TAVR procedure were included in this retrospective analysis.
All patients had severe aortic valve stenosis and did not qualify for surgical treatment.
In the context of the pre-procedural planning,
the aortic root complex,
the thoraco-abdominal aorta,
and the iliofemoral arteries were evaluated by CTA. Scan Protocol All scans were performed on a second generation DSCT system (Somatom Definition Flash,...
Demographics 15 patients received full amounts of contrast medium,
while 22 patients had been investigated with 60 mL of CM.
Comparison of demographic characteristics showed no significant difference: gender distribution (53.3% female,
p = 0.734),
age (78.9 years ± 12.1 years,
82.8 years ± 9.8 years,
p = 0.295),
body mass index (30.8 kg/m 2 ± 9.1,
26.4 ± 4.4,
p = 0.100). Image Quality Table 2 provides an overview of the measurements.
Regarding the cardiac CT scan,
In TAVR planning,
the performance of a combined CT protocol consisting of a retrospectively ECG-gated cardiac CTA immediately followed by a high-pitch scan of the aortoiliac access route is feasible.
With this approach,
the amount of contrast medium can be considerably reduced by using a single low volume CM bolus without substantial loss of image quality.
Transcatheter versus surgical aortic-valve replacement in high-risk patients. N Engl J Med 2011;364:2187-98. 2.
The evolving role of MDCT in transcatheter aortic valve replacement: a radiologists' perspective. AJR Am J Roentgenol 2009;193:W214-9. 3.
Combined assessment of aortic root anatomy and aortoiliac vasculature with dual-source CT as a screening tool in patients evaluated...
Department of Radiology and Radiological Science
Medical University of South Carolina
25 Courtenay Drive,
e-mail: firstname.lastname@example.org or Dr.
Department of Clinical Radiology
University Hospitals LMU Munich