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

OBJECTIVES: 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.

CONCLUSIONS: This review outlines the principal aspects of TAVR, the multidisciplinary approach and utilization 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. 

PMID: 24443171

Posted in Computed Tomography, Echo, Invasive Imaging and tagged , .

One Comment

  1. See also:

    SCCT Expert Consensus Document on Computed Tomography Imaging Before Transcatheter Aortic Valve Implantation (TAVI)/Transcatheter Aortic Valve Replacement (TAVR).
    Achenbach S, Delgado V, Hausleiter J, Schoenhagen P, Min JK, Leipsic JA.
    J Cardiovasc Comput Tomogr. 2012; 6(6):366-380.

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