Learning objectives
• Appropriate selection of patients who will benefit from said study,
decreasing the flaws in the procedure.
• Perform a good surgical planning,
as well as the correct measurements,
approach and correct device selection.
• Perform the correct preparation of a good radiological report that allows the surgeon to develop a successful therapeutic procedure.
Background
Degenerative aortic valve stenosis is the most frequent cause of acquired valvulopathy in the western world.
Aortic valve stenosis is an obstruction of the LV outlet tract with an aortic jet velocity> 4m / sec,
a gradient> 40-50 mmHg and a valvular area <1 cm2,
is considered critical stenosis when a valvular area is present < of 0.6 cm2.
The incidence is 5% world population being 2-3%> 75 years.
In asymptomatic patients the survival <50% at 2 years.
The surgical option in valve replacement was...
Findings and procedure details
TAVR(Transcatheter aortic valve replacement)is a therapeutic alternative to conventional surgery,
which consists of the placement of an aortic valve bioprosthesis,
which replaces the native valve displacing it against the aortic wall in the deployment.
There are two main approaches for the implantation of the prosthesis:
-Peripherally: trans-femoral and subclavian.
-Transapical route (through the apex of the left ventricle),
which is used in cases in which the former is contraindicated.
Whatever the path of choice is necessary to know the anatomy of the cardiac valvular apparatus,...
Conclusion
Angiotomography in a percutaneous aortic vascular replacement is a valuable tool for cardiovascular surgeons since it allows them to perform surgery and management in patients with a contraindication to valve replacement surgery.
A good analysis of all the elements described has an impact on the patient's management,
helps to decide the most appropriate access,
individualize the characteristics of the prosthesis to each patient and detects some of the general exclusion criteria (mainly related to the anatomy of the valvular apparatus) and other situations that contraindicate...
Personal information
Dr.AbramzonFernando.
ChiefofDepartamentofRadiology,HospitaldetraumaDrFedericoAbete.
Malvinas Argentinas,BuenosAires.Argentina
Email:
[email protected]
Dra.Crosta Julieta
Chiefofultrasound,HospitaldetraumaDrFedericoAbete.
MalvinasArgentinas,Buenos Aires.Argentina
Email:
[email protected]
DepartamentofRadiology,HospitaldetraumaDrFedericoAbete.
Chief resident.
Dra.
Narvaez Yuly.
Residetintraining.
Dra.LealGrettel.
Dr.
Carreño Henry
Dr.
Averanga Gustavo
Dr.
Palacios Leyder.
References
1.
Role of imaging techniques in the TAVI.
Does the technique used influence the results?
Artur Evangelista a,
Teresa González-Alujas a,
Hug Cuellar a,
Laura Gutiérrez.
Vall d'Hebron University General Hospital,
Barcelona,
Spain.
2.
CT in Transcatheter Aortic Valve Replacement
Philipp Blanke1,U.
Joseph Schoepf,Jonathon A.
Leipsic
Radiology: Volume 269: Number 3—December 2013
3.Preprocedural CT Evaluation of Transcatheter Aortic Valve Replacement: What the Radiologist Needs to Know
Rodrigo A.
Salgado,Jonathon A.
Leipsic,Bharati Shivalkar,Lenz Ardies,Paul L.
Van Herck,Bart J.
Op de Beeck,Christiaan Vrints,Inez Rodrigus,Paul M.
Parizel,Johan Bosmans...