scholarly journals CT imaging prior to transcatheter aortic valve implantation in the UK

Open Heart ◽  
2020 ◽  
Vol 7 (1) ◽  
pp. e001233
Author(s):  
Iwan Harries ◽  
Jonathan R Weir-McCall ◽  
Michelle C Williams ◽  
James Shambrook ◽  
Giles Roditi ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Transcatheter Aortic Valve Implantation ◽  
Cardiac Ct ◽  
High Volume ◽  
British Society ◽  
Volume Activity ◽  
Transcatheter Aortic Valve ◽  
Aortic Valve Implantation ◽  
The Uk ◽  
Valve Implantation

ObjectiveThis cross-sectional observational study sought to describe variations in CT in the context of transcatheter aortic valve implantation (CT-TAVI) as currently performed in the UK.Methods408 members of the British Society of Cardiovascular Imaging were invited to complete a 27-item online CT-TAVI survey.Results47 responses (12% response rate) were received from 40 cardiac centres, 23 (58%) of which performed TAVI on-site (TAVI centres). Only six respondents (13%) performed high-volume activity (>200 scans per year) compared with 13 (28%) performing moderate (100–200 scans per year) and 27 (59%) performing low (0–99 scans per year) volume activity. Acquisition protocols varied (41% retrospective, 12% prospective with wide padding, 47% prospective with narrow padding), as did the phase of reporting (45% systolic, 37% diastolic, 11% both, 6% unreported). Median dose length product was 675 mGy.cm (IQR 477–954 mGy.cm). Compared with non-TAVI centres, TAVI centres were more likely to report minimum iliofemoral luminal diameter (n=25, 96% vs n=7, 58%, p=0.003) and optimal tube angulation for intervention (n=12, 46% vs n=1, 8%, p=0.02).ConclusionsThis national survey formally describes current CT-TAVI practice in the UK. High-volume activity was only present at one in seven cardiac CT centres. There is wide variation in scan acquisition, scan reporting and radiation dose exposure in cardiac CT centres.

Impact of renal function on survival after transcatheter aortic valve implantation (TAVI): an analysis of the UK TAVI registry

Heart ◽  
2015 ◽  
Vol 101 (7) ◽  
pp. 546-552 ◽  
Author(s):  
Charles J Ferro ◽  
Colin D Chue ◽  
Mark A de Belder ◽  
Neil Moat ◽  
Olaf Wendler ◽  
...  
Keyword(s):  
Renal Function ◽  
Aortic Valve ◽  
Transcatheter Aortic Valve Implantation ◽  
Transcatheter Aortic Valve ◽  
Aortic Valve Implantation ◽  
The Uk ◽  
Valve Implantation

scholarly journals P1718 Multi-modal imaging characterization of contained aortic subannular rupture after transcatheter aortic valve implantation

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
P Grilo Diogo ◽  
C X Resende ◽  
A Nunes ◽  
P Araujo ◽  
S Torres ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Transcatheter Aortic Valve Implantation ◽  
Aortic Root ◽  
Cardiac Ct ◽  
Left Ventricular ◽  
Paravalvular Leak ◽  
Chest Discomfort ◽  
Transcatheter Aortic Valve ◽  
Aortic Valve Implantation ◽  
Valve Implantation

Abstract INTRODUCTION Aortic annular rupture is a potentially catastrophic complication after transcatheter aortic valve implantation (TAVI), with an estimated incidence of 1%. Rupture occurs in the anatomical device landing zone, that extends from the aortic root to the distal left ventricular outflow tract (LVOT). It usually occurs in the context of highly calcified aortic valve and LVOT, implantation of balloon-expandable valves, valve oversizing and overdilation to treat paravalvular leakage. CASE REPORT An 80-year old woman with no past relevant medical history was admitted to our Cardiology Department with decompensated heart failure because of symptomatic severe aortic stenosis, moderate aortic regurgitation and mild left ventricular (LV) dysfunction. She was already in waiting list for TAVI procedure, after being refused for conventional aortic valve replacement due to a "porcelain" aorta. Her pre-operative angiography showed no significant coronary heart disease, and the cardiac computed tomography (cardiac-CT) revealed a severely calcified aortic valve (Agatston score = 4940). An Acurate neo L (27mm) valve was implanted after clinical stabilization with no immediate complications. Because of paravalvular regurgitation, sequential post-dilation was performed with 25mm and 26mm balloons. Post-procedural angiography showed no contrast extravasation (Panel A). In the first hours after the procedure, she was hypotensive with non-specific mild chest discomfort. The EKG showed sinus rhythm with left anterior fascicular block. A transthoracic echocardiogram revealed a moderate pericardial effusion, with no signs of tamponade, and a moderate "paravalvular leak "at the level of the non-coronary cusp to a pulsatile cavity, between the aortic root and the left atrium (Panel B and C). The patient evolved with haemodynamic and electrical stability with no recurrence of chest discomfort. A retrospective cardiac-CT was performed that confirmed the presence of a multilobular cavity below the left coronary artery in continuous with the LVOT, compatible with a contained subannular aortic rupture (Panel E and F), at the level of previous gross calcification in the pre-operative cardiac-CT (Panel D). The case was discussed in Heart Team and a conservative strategy was adopted due to clinical stability and inoperable condition. The patient was discharged at day 28, after CT reavaluation,, that demonstrate similar findings. CONCLUSION We report a rare and potentially fatal complication of TAVI with a self-expandable valve. This clinical case illustrates how balloon post-dilation to treat moderate post-procedural paravalvular regurgitation lead to tearing of a highly calcified aortic annulus. A multi-modality imaging approach, with echocardiography and computer tomography, was essential for full anatomical definition of the subannular rupture, clinical decision-making and for follow-up surveillance. Abstract P1718 Figure. Panel A,B,C,D,E,F.

scholarly journals Comparative Survival After Transapical, Direct Aortic, and Subclavian Transcatheter Aortic Valve Implantation (Data from the UK TAVI Registry)

2015 ◽  
Vol 116 (10) ◽  
pp. 1555-1559 ◽  
Author(s):  
Georg M. Fröhlich ◽  
Paul D. Baxter ◽  
Christopher J. Malkin ◽  
D. Julian A. Scott ◽  
Neil E. Moat ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Transcatheter Aortic Valve Implantation ◽  
Transcatheter Aortic Valve ◽  
Aortic Valve Implantation ◽  
The Uk ◽  
Valve Implantation
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