To explain the rationale for the use of multidetector computed tomography (MDCT) angiography in the preoperative planning of percutaneous mitral valve repair procedures To show the MDCT image acquisition protocols and post-processing techniques available for treatment planning To discuss the main findings that radiologists need to assess,
illustrate and report for optimal preoperative planning of such procedures.
The mitral valve complex: anatomical considerations The mitral valve (MV) complex is composed of the following parts: mitral annulus two leaflets (anterior and posterior) chordae tendineae papillary muscles( Fig. 1 ) 1.
The mitral annulus demarcates the insertion area of the MV leaflets and has a saddle-shaped spatial configuration.
It is a fibrotic ring that can be divided into an anterior and a posterior portion: the anterior portion lies between the right and the left trigone of the...
Findings and procedure details
MDCT image acquisition protocol 1.
General considerations MDCT is the imaging modality of choice for interventional planning in patients with MR candidate to percutaneous MV repair.
Cardiac MDCT has several strengths,
including: excellent spatial resolution (≃0.5-0.6mm) with voxel isotropy,
allowing for high quality 2D and 3D reconstructions of the MV and subvalvular apparatus high reproducibility and relative operator-independence direct visualisation and quantification of mitral...
Percutaneous MV repair is gaining increasing acceptance as an alternative to surgery in patients at prohibitively high surgical risk. Radiologists should become familiar with imaging findings in patients undergoing MDCT forplanning of percutaneous MV repair.
A tight interaction between radiologists and interventional cardiologists is essential to optimise imaging acquisition protocols and streamline reporting.
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