The aim of our study is to show the importance of precise evaluation of aortic anulus size, coronary ostia height, aortic valve shape and access vessels evaluation in patients undergoing trans-catheter aortic valve implantation (TAVI). These tools are fundamental in pre-procedural evaluation and management of TAVI candidates.

Between June 2017 and January 2019, 323 patients with severe aortic stenosis, not eligible for surgery, were enrolled for TAVI at the Interventional Cardiology Department of Tor Vergata Polyclinic. All patients underwent pre-procedural diagnostic examination: 218 patients without chronic kidney disease were examined by Computed Tomography Angiography (CTA) using a retrospectively ECG-triggered high-pitch spiral acquisition mode with low-dose radiation, other 105 patients with chronic kidney disease were divided in two groups: 78 patients with 30 ml/min < eGFR < 45 ml/min were studied by a...

CT is a gold standard methodic for pre-TAVI planning because allows accurate visualization and measures of the aortic anulus coronary ostia, height evaluation of arterial calcifications and peripheral vascular accesses and also extracardiac findings. Furthermore our study shows that acquisition protocol with low-dose contrast injection allows the operator to adequately visualize the intima of the large vessels and the segments of the aortic valve system in order to obtain adequate measures Fig. 1. Non contrast MRI 2D sequences offer a promising approach, because the aortic...

From our experience in the pre-procedural evaluation of TAVI candidates is fundamental to adapt each patient to the best protocol, in order to minimize possible complications and improve the quality of planning.

Federica Di Tosto, MD Department of Diagnostic Imaging, Molecular Imaging, Interventional Radiology and Radiation Teraphy PTV Foundation, "Tor Vergata Hospital" University of Rome "Tor Vergata" Viale Oxford, 81 - 00133, Roma, Italy E-mail: [email protected]

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