Impact of Electrocardiogram-Gated Multi-Slice Computed Tomography-Based Aortic Annular Measurement in the Evaluation of Paravalvular Leakage Following Transcatheter Aortic Valve Replacement: The Efficacy of the OverSized AortiC Annular Ratio (OSACA Ratio)

2013 ◽  
Vol 28 (4) ◽  
pp. 373-379 ◽  
Author(s):  
Koichi Maeda ◽  
Toru Kuratani ◽  
Kei Torikai ◽  
Kazuo Shimamura ◽  
Isamu Mizote ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Transcatheter Aortic Valve Replacement ◽  
Paravalvular Leakage ◽  
Transcatheter Aortic Valve

scholarly journals Pathologic confirmation of valve thrombosis detected by four-dimensional computed tomography following valve-in-valve transcatheter aortic valve replacement

2017 ◽  
Vol 2017 (2) ◽  
Author(s):  
Ambarish Gopal ◽  
Nathalia Ribeiro ◽  
John J Squiers ◽  
Elizabeth M Holper ◽  
Michael Black ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Transcatheter Aortic Valve Replacement ◽  
Thrombus Formation ◽  
Imaging Modality ◽  
4D Ct ◽  
Transcatheter Aortic Valve ◽  
Valve Thrombosis

A major concern regarding transcatheter aortic valve replacement (TAVR) is leaflet thrombosis. Four-dimensional computed tomography (4D-CT) is the preferred imaging modality to evaluate patients with suspected valve thrombosis. To date, the abnormal findings visualized by 4D-CT suggestive of leaflet thrombosis have lacked pathologic confirmation from a surgically explanted valve in a surviving patient. Herein, we provide pathologic confirmation of thrombus formation following surgical explantation of a thrombosed TAVR prosthesis that was initially identified by 4D-CT. 

Abstract 17600: Improved Iterative Reconstruction Reduces Artifacts and Results in Larger Measurements of Ileofemoral Artery Size on Computed Tomography in Patients Referred for Transcatheter Aortic Valve Replacement

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Anum Minhas ◽  
Smita Patel ◽  
Ella Kazerooni ◽  
Antonio Conte ◽  
Troy Labounty
Keyword(s):  
Computed Tomography ◽  
Image Quality ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Iterative Reconstruction ◽  
Transcatheter Aortic Valve Replacement ◽  
Beam Hardening ◽  
Transcatheter Aortic Valve ◽  
Blinded Reader

Background: Computed tomography (CT) is typically used to measure ileofemoral artery size in patients considered for transcatheter aortic valve replacement (TAVR). However, these patients often have significant arterial calcification, which can introduce artifacts and limit measurement accuracy. We hypothesized that improved iterative reconstruction would improve image quality and reduce artifacts, resulting in larger measured size. Methods: We examined 56 patients undergoing CT for possible TAVR, and compared image quality and ileofemoral arterial size between separate reconstructions of the same studies, comparing standard (STD) advanced statistical iterative reconstruction and improved model-based iterative reconstruction (MBIR). A blinded reader identified the sites with the smallest luminal diameter, and provided identical short-axis reformats for both reconstructions. A separate blinded reader graded image quality and made measurements in a random sequence. We compared mean and minimal diameters, image quality (1 poor, 4 excellent), and signal and noise. Results: Mean age was 77 ± 10 years and 54% were male. Table 1 compares measured diameters and image quality between STD and MBIR reconstructions. Between STD and MBIR images, ≥moderate beam-hardening artifacts were observed in 30% (17/56) and 9% (5/56) of patients, respectively (p=0.008); severe artifacts were seen in 23% (13/56) and 5% (3/56) of patients, respectively (p=0.01). Overall image quality of STD and MBIR images was graded as good or excellent in 70% (39/56) and 91% (51/56) of cases, respectively (p=0.008). Conclusion: In patients referred for TAVR, improved iterative reconstruction resulted in higher image quality, fewer beam-hardening artifacts, and larger measurements of ileofemoral artery size.

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