To describe the crucial role of non-invasive imaging to correctly plan trans-catheter aortic valve implantation (TAVI) procedures To describe a case of valve-in-valve (VIV) procedure in a malfunctioning sutureless bio-prosthetic surgical heart valves (BSHV) using a self-expandable trans-catheter heart valve (SE-THV) To assess the evolving importance of the radiographer in this setting
Aortic stenosis (AS) ,
a degenerative valvular heart disease,
is a major cause of morbidity and mortality in the aging population of industrialized countries [1-2].
Trans-catheter aortic valve implantation (TAVI) has emerged as a viable treatment option for patients with severe native aortic valve stenosis at high or moderate risk for surgery . Bio-prosthetic surgical heart valves (BSHV) ,
on the other side,
have limited durability leading to degeneration and subsequent malfunction....
Findings and procedure details
1.THE ROLE OF THE RADIOGRAPHER BEFORE THE PROCEDURE In our Center,
TAVI procedural planning requires different exams such as echocardiography,
peripheral and carotid echography,
chest X-ray and retrospective gated cardio-vascular CT scan. Computed Tomography (CT) has been gaining a key role in the pre-procedural work-up needed for patients with symptomatic AS referred for TAVI. The critical important parameters and measurements that are included in pre-procedural TAVI are the followings [...
The radiographer is now an essential part of a team that evaluates and treats the patient selected for the TAVI procedure,
with a role that has new features with multiple competences,
due to the evolvingimportance of the different imaging modalities.The radiographer is currently important to help the team before , during and after the procedure,
with MDCT imaging acquisition and reconstruction,
the THV systemsloading,
careful contrast dye injection,
optimization of the best fluoroscopic view...
Contact Details: DEPARTMENT OF INTERVENTIONAL CARDIOLOGY,
SANT'AMGROGIO CLINICAL INSTITUTE (16,
Luigi Giuseppe Faravelli street,
Francesca Messina Email: firstname.lastname@example.org Dr Massimo Medda Email:email@example.com Dr.
Marta Bande Email:firstname.lastname@example.org Dr.
Francesco Casilli Email: email@example.com Dr Alfonso Ielasi Email:firstname.lastname@example.org Dr Antonio Silvestro Email: email@example.com Dr Michele Criscuolo...
1. Nkomo VT,
Burden of valvular heart diseases: a population-based study.
Lancet 2006; 368:1005-11. 2. Bonow RO,
ACC/ AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (writing Committee to Revise the 1998 guidelines for the management of patients with valvular heart disease) developed in...