Transcatheter aortic valve implantation

2021 ◽  
pp. 315-336
Author(s):  
Arnold C.T. Ng ◽  
Victoria Delgado ◽  
Jeroen J. Bax
Keyword(s):  
Computed Tomography ◽  
Aortic Valve ◽  
Transcatheter Aortic Valve Implantation ◽  
Transthoracic Echocardiography ◽  
Multimodality Imaging ◽  
Imaging Modality ◽  
Severe Aortic Stenosis ◽  
Transcatheter Aortic Valve ◽  
Aortic Valve Implantation ◽  
Valve Implantation

Transcatheter aortic valve implantation (TAVI) is an established therapy for patients with symptomatic severe aortic stenosis and contraindications for surgical aortic valve replacement or with intermediate and high operative risk in whom the heart team considers that TAVI is the best therapeutic option. Accurate patient selection strongly relates on multimodality imaging consisting mostly of the combination of transthoracic echocardiography and computed tomography. To guide the procedure, fluoroscopy is the mainstay imaging modality. In the follow-up of the patients, transthoracic echocardiography and computed tomography are again the main imaging modalities to use. Cardiovascular magnetic resonance and nuclear imaging have a minimal role in this area.

scholarly journals Pre-interventional assessment and calcification score of the aortic valve and annulus, with multi-detector CT, in transcatheter aortic valve implantation (TAVI) using the Medtronic CoreValve

2015 ◽  
Vol 19 (1) ◽  
Author(s):  
Antoinette Reinders ◽  
Coert S. De Vries ◽  
G. Joubert
Keyword(s):  
Computed Tomography ◽  
Aortic Valve ◽  
Transcatheter Aortic Valve Implantation ◽  
Scoring System ◽  
Multimodality Imaging ◽  
Final Analysis ◽  
Paravalvular Leak ◽  
Transcatheter Aortic Valve ◽  
Aortic Valve Implantation ◽  
Valve Implantation

Background: Transcatheter aortic valve implantation (TAVI) provides an acceptable alternative for aortic valve replacement in the elderly, but needs accurate pre-procedural imaging to optimise intervention. Objectives: To evaluate an alternative manual aortic valve calcification scoring system with computed tomography, for patients undergoing TAVI. We hypothesise a correlation between the Free State aortic valve calcium computed tomography score (FACTS) scoring system, valve plaque density and procedure-related complications. Methods: Twenty patients suitable for TAVI were selected according to standard international guidelines and received multimodality imaging prior to intervention. Images were reviewed by two reviewers who were blinded to each other’s scores. Where large inter-individual score variations existed, retraining was done and scores repeated, using a double-blinded method. Matched scores were included in the final analysis. Rosenhek calcification scores were used as a standard of reference. Results: The study comprised 9 (45%) men and 11 (55%) women, with a median age of 83.5 years. Median EuroSCORE was 15.5. FACTS scores ≥6 were associated with the presence of a paravalvular leak (p = 0.01). Procedure-related complications (left bundle branch block, repositioning of the valve and anaemia) were seen in patients with plaques measuring ≥1000 HU (p = 0.07). Conclusion: The FACTS score and averaged valve plaque HU showed potential for predicting a paravalvular leak and procedure-related complications, and could be valuable in the future for optimising patient selection for TAVI.

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