The purpose of this exhibit is to present what needs to be assessed,using MDCT multiplanar imaging,
before aortic valve implantation.
In recent times,
the development of transcatheter aortic valve implantation (TAVI) allowed an achievable way to treat symptomatic severe aortic stenosis,
a disease with poor prognosis within two years if left untreated.
The pre-procedural imaging evaluation of patients who are candidates for TAVI is necessary to determine the most suitable device and percutaneous approach; it involves the assessment of the aortic valvular complex,
including aortic valve,
anatomy of the aorta and peripheral arteries,
to select the access site.
Findings and procedure details
evaluation of the aortic valve should begin with conﬁrmation of the aortic valve morphology (Fig.1),
differentiating tricuspid from bicuspid valvular anatomy.
The accuracy can be further improved with additional systolic reconstruction using ECG-gating,
which permits differentiation between a bicuspid valve with raphe and a tricuspid valve .
the assessment of the extent and location of the aortic valve calciﬁcation is important (Fig.1):very bulky calciﬁcation at the edge of native valvular leaﬂets has been related to increased risk of coronary occlusion when it is...
MDCT plays a central role in pre-TAVI assessment as it provides a global and specific cardiac evaluation of the anatomy prior to the procedure.
3D volumetric data sets allow unlimited plane reconstructions,
fundamental in pre-procedural screening and procedural planning,
minimizing post procedural complications.
A correct post processing protocol is mandatory to select the most appropriate procedural approach and the material to be implanted,
which may help to anticipate and thus avoid potential procedural complications.
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Trindade PT et al (2010) Cardiac CT for the differentiation of bicuspid and tricuspid aortic valves: comparison with echocardiography and surgery.
Am J Roentgenol 195:900–908
2) Webb JG,
Thompson CR et al (2006) Percutaneous aortic valve implantation retrograde from the femoral artery.
3) Kapadia SR,
Stewart W et al (2010) Imaging for transcatheter valve procedures.
Curr Probl Cardiol 35:228–276
4) Smid M,
Baxa J et al (2010) Aortic annulus and ascending aorta:...