Updates on Transcatheter Aortic Valve Replacement and the Role of Multi-Detector Computed Tomography: What a Radiologist Should Know
Cardiovascular Imaging Asia 2018³â 2±Ç 3È£ p.110 ~ p.122
(Mo Yuan-Heng) - Cathay General Hospital Department of Radiology
(Kuo Yen-Shu) - Cathay General Hospital Department of Radiology
(Wang Yung-Cheng) - Cathay General Hospital Department of Radiology
(Wu MIng-Ting) - Kaohsiung Veterans General Hospital Department of Radiology
Abstract
The indications of the transcatheter aortic valve replacement (TAVR) procedure have been widely expanded and the number of cases has significantly increased in the past 15 years due to continued evolution of prosthetic devices, increased experience of cardiologists, and advancements in the cardiovascular imaging field. In this review article, we summarize updates on TAVR guidelines, state-of-the-art prosthetic devices, recommended pre- and post-procedural multi-detector computed tomography (MDCT) protocols, required imaging parameters and measurements, and post-procedural complications. We also address issues concerning the Asian population and patients with bicuspid aortic valve and emphasize some of the challenges ahead. MDCT is the recommended modality of choice for pre-procedural planning for TAVR and current guidelines state that MDCT should be performed by well-trained personnel and interpreted and analyzed by experienced radiologists who not only have a sound understanding of TAVR with respect to its indications, prosthetic devices, procedure, and complications, but also work in close collaboration with the Heart Team.
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Transcatheter aortic valve replacement, Multidetector computed tomography, Aortic valve stenosis, Aortic dissection
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MDCT is the recommended image modality for pre-procedural planning of the TAVR procedure