Computed tomography imaging in the context of transcatheter aortic valve implantation (TAVI) / transcatheter aortic valve replacement (TAVR): An expert consensus document of the Society of Cardiovascular Computed Tomography

Blanke, Philipp; Weir‐McCall, Jonathan R.; Achenbach, Stephan; Delgado, Victoria; Hausleiter, Jörg; Jilaihawi, Hasan; Marwan, Mohamed; Nørgaard, Bjarne Linde; Piazza, N; Schoenhagen, Paul; Leipsic, Jonathon

doi:10.1016/j.jcct.2018.11.008

Cited by 320 publications

(237 citation statements)

References 99 publications

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“…The most recent recommendations for preprocedural CT scanning issued by the Society of Cardiovascular Computed Tomography (SCCT) require a contrast-enhanced, ECG-synchronized CT scan that should at least cover the aortic root [8]. Other body parts can be imaged without ECG synchronization.…”

Section: Introductionmentioning

confidence: 99%

Radiation Dose Reduction in Preprocedural CT Imaging for TAVI/TAVR Using a Novel 3-Phase Protocol: A Single Institution’s Experience

Shnayien

Bressem

Beetz

et al. 2020

Rofo

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Purpose To retrospectively investigate the effectiveness of a novel 3-phase protocol for computed tomography (CT) before transcatheter aortic valve implantation/transcatheter aortic valve replacement (TAVI/TAVR) in terms of radiation dose and image quality. Materials and Methods A total of 107 nonrandomized patients (81 ± 7.4 years) scheduled for TAVI/TAVR underwent preprocedural CT on an 80-row CT scanner. 55 patients underwent a combined ECG-synchronized spiral scan of the chest and non-ECG-synchronized spiral scan of the abdomen/pelvis as recommended by the Society of Cardiovascular Computed Tomography (SCCT). 52 patients underwent an updated 3-phase variable helical pitch (vHP3) protocol combining a non-ECG-synchronized spiral scan of the upper thoracic aperture, followed by a prospective ECG-synchronized spiral scan of the heart, and a non-ECG-synchronized abdominal/pelvic spiral scan. The radiation dose was determined from an automatically generated protocol based on the CT dose index (CTDI). Objective image quality in terms of vessel attenuation and image noise was measured, and the signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were calculated. Subjective image quality was evaluated using a 4-point scale and compared for interrater agreement using Cohen’s weighted kappa coefficient (κw). All data were compared and statistically analyzed. Results Use of the novel 3-phase vHP3 protocol reduced the dose-length product (DLP) from 1256.58 ± 619.05 mGy*cm to 790.90 ± 238.15 mGy*cm, reducing the effective dose (E) from 21.36 ± 10.52 mSv to 13.44 ± 4.05 mSv and size-specific dose estimates (SSDE) from 20.85 ± 7.29 mGy to 13.84 ± 2.94 mGy (p < 0.001). There were no significant differences in objective and subjective image quality between the two protocols and between the two readers. Conclusion The novel 3-phase vHP3 protocol significantly reduces the radiation dose of preprocedural TAVI/TAVR CT without a loss of image quality. Key Points: Citation Format

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Section: Introductionmentioning

confidence: 99%

Radiation Dose Reduction in Preprocedural CT Imaging for TAVI/TAVR Using a Novel 3-Phase Protocol: A Single Institution’s Experience

Shnayien

Bressem

Beetz

et al. 2020

Rofo

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“…Secondly, deviations in measurements due to selected cardiac phases. As the software used for analysis was unable to perform the automatic segmentation of the ascending aorta in pigs, all measurements of the aortic root were performed with the valve closed to facilitate accurate manual identification of the most basal attachment points of the three aortic valve cusps needed for quantitative assessment of the annulus plane 45 . All other valves were subsequently also measured in the closed position although intra-cardiac cycle variations are known to have a marked influence on cardiac dimensions and indices of cardiac functions in humans 46 with differences of up to 15% expected when using different cardiac phases 47 .…”

Section: Discussionmentioning

confidence: 99%

Computed Tomography-based evaluation of porcine cardiac dimensions to assist in pre-study planning and optimized model selection for pre-clinical research

Lipiski¹,

Eberhard²,

Fleischmann³

et al. 2020

Sci Rep

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Hatem Alkadhi 2 & nikola cesarovic 1,7 the pig (Sus Scrofa Domestica) is an accepted model for preclinical evaluation of prosthetic heart valves and trans-catheter implantation techniques. Understanding porcine cardiac dimensions through threedimensional computed tomography (ct), increases preclinical study success, leading to higher cost efficiency and to the observance of the obligation to the 3 R principles. Cardiac CT images of twentyfour Swiss large white pigs were segmented; aortic root, mitral valve, pulmonary trunk, tricuspid valve, as well as the aorto-mitral angle and left atrial height were analyzed. Correlation coefficient (r) was calculated in relation to body weight. In Swiss large white pigs, valvular dimensions, length of the pulmonary artery and ascending aorta as well as left atrial height correlate with body weight. Coronary ostia heights and aorto-mitral angle size can be neglected in animal size selection; no changes were found for either of the two parameters with increasing body weight.

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“…Moreover, procedural difficulty increases if patients have the following access problems: horizontal aorta, tortuous aorta, or poor peripheral access. 15 In cases of such TAVI-specific anatomic risks, SAVR becomes the preferred option.…”

Section: Discussionmentioning

confidence: 99%

Contemporary Outcomes of Surgical Aortic Valve Replacement in Japan

Tokuda¹,

Yamamoto

Matsubara

et al. 2020

Circ J

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aim of this study was to analyze recent trends in patient characteristics and outcomes of SAVR in the real-world situation in Japan. The Japan Cardiovascular Surgery Database (JCVSD), a national registry in Japan, was used to evaluate the outcomes. Methods JCVSD The JCVSD is a national database used to assess surgical outcomes after cardiovascular procedures on a multicenter basis throughout Japan. The JCVSD adult division currently captures clinical information from 99% of Japanese hospitals performing cardiovascular surgery (as of 2017). 6 The data collection form has a total of >250 variables (definitions available online at http://www.jacvsd.umin.jp), which are derived from those in the Society of Thoracic Surgeons (STS) National Database (definitions available online at http://sts.org). The methods used for data collection for the JCVSD have been described previously. 7 Data collection achieved a high completion level, with missing

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Computed tomography imaging in the context of transcatheter aortic valve implantation (TAVI) / transcatheter aortic valve replacement (TAVR): An expert consensus document of the Society of Cardiovascular Computed Tomography

Cited by 320 publications

References 99 publications

Radiation Dose Reduction in Preprocedural CT Imaging for TAVI/TAVR Using a Novel 3-Phase Protocol: A Single Institution’s Experience

Radiation Dose Reduction in Preprocedural CT Imaging for TAVI/TAVR Using a Novel 3-Phase Protocol: A Single Institution’s Experience

Computed Tomography-based evaluation of porcine cardiac dimensions to assist in pre-study planning and optimized model selection for pre-clinical research

Contemporary Outcomes of Surgical Aortic Valve Replacement in Japan

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