Keywords:
Not applicable, Prospective, Image verification, Technical aspects, CT-Angiography, CT, Contrast agents, Cardiovascular system, Arteries / Aorta, Performed at one institution
Authors:
G. S. Gallo1, R. Gerasia1, C. Caruso1, C. Tafaro1, C. Cannataci2, G. Gentile1, G. Mamone3, R. Miraglia4; 1Palermo/IT, 2Msida/MT, 3Palermo, It/IT, 4Palermo /IT
DOI:
10.26044/ecr2020/C-08062
Purpose
Many patients with severe aortic stenosis and multiple co-morbidities are not suitable candidates for surgical replacement of the aortic valve. Transcatheter aortic-valve implantation (TAVI) is a new procedure, in which a bioprosthetic valve is inserted through a catheter and implanted within the diseased native aortic valve. Computed Tomography Angiography (CTA) has become the standard non-invasive imaging method for accurate preliminary aortic annulus sizing and aorto-iliac artery evaluation for TAVI procedure planning. The main limitations of CTA in elderly patients with high-BMI is the large amount of iodinated contrast media (CM) needed to visualize the entire aorta and the ilio-femoral access site. The CM required may pose a risk for TAVI candidates who frequently suffer from impaired renal function and are considered to be at increased risk of contrast-induced nephropathy (CIN). An ultra-low volume contrast medium (40-55 mL) 64-slice CTA protocol for TAVI candidates with a body mass index (BMI) ≤ 29 kg/m2 has already been described in the literature1, however no similar data are currently available for TAVI candidates with a high BMI. This study aims to investigate the feasibility of a low-volume contrast medium (65 mL) 64-slice CTA protocol in patients with BMI >29 kg/m2 scheduled for TAVI, by evaluating the image quality of both aortic annulus and aorto-iliac arteries, and assessing the accuracy of CT measurements of annulus sizes.