Computed Tomography Imaging in the Context of Transcatheter Aortic Valve Implantation (TAVI)/Transcatheter Aortic Valve Replacement (TAVR)

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.jcmg.2018.12.003

Cited by 334 publications

(231 citation statements)

References 96 publications

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“…Precise assessment of maximal aortic root dimensions and the minimum distance between the annulus and coronary ostia are desirable for TAVI planning in order to minimize the risk of post-procedural paravalvular leakage and/or coronary ostium occlusion [3]. Although the 2019 SCCT guidelines state provide no recommendation whether the coronary ostia height should be measured in systole or diastole [14], the results of the current study show that the largest aortic annulus dimension and also the smallest annulus-coronary ostia distances are ideally measured during max-systole.…”

Section: Discussionmentioning

confidence: 99%

“…Pre-TAVI measurements were assessed in a blinded manner on the retrospectively ECG-gated scans at all 10%-time intervals of the cardiac cycle (0-100%) and on the non-ECG-synchronized scan. The anatomical structures of the aortic root were assessed in accordance with SCCT expert consensus guidelines [14]. Effective diameters, derived from the perimeter (D P ) and annular area (D A ), were calculated with commonly used formulas [18].…”

Section: Aortic Annulus Measurementsmentioning

confidence: 99%

“…The ambiguity has not been solved in the 2019 version of the SCCT guidelines, where the recommended acquisition method is dependent on manufacturer and/or type of CT-scanner [14]. Moreover, the use of ultra-high-pitch imaging, which offers the possibility to capture the…”

Section: Introductionmentioning

confidence: 99%

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Retrospectively ECG-gated helical vs. non-ECG-synchronized high-pitch CTA of the aortic root for TAVI planning

et al. 2020

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Background Multidetector computed tomography (MDCT) plays a key role in patient assessment prior to transcatheter aortic valve implantation (TAVI). However, to date no consensus has been established on what is the optimal pre-procedural imaging protocol. Variability in pre-TAVI acquisition protocols may lead to discrepancies in aortic annulus measurements and may potentially influence prosthesis size selection. Purpose The current study evaluates the magnitude of differences in aortic annulus measurements using max-systolic, end-diastolic, and non-ECG-synchronized imaging, as well as the impact of method on prosthesis size selection. Material and methods Fifty consecutive TAVI-candidates, who underwent retrospectively-ECG-gated CT angiography (CTA) of the aortic root, directly followed by non-ECG-synchronized high-pitch CT of the entire aorta, were retrospectively included. Aortic root dimensions were assessed at each 10% increment of the R-R interval (0-100%) and on the non-ECG-synchronized scan. Dimensional changes within the cardiac cycle were evaluated using a 1-way repeated ANOVA. Agreement in measurements between max-systole, end-diastole and non-ECGsynchronized scans was assessed with Bland-Altman analysis.

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Section: Discussionmentioning

confidence: 99%

Section: Aortic Annulus Measurementsmentioning

confidence: 99%

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Retrospectively ECG-gated helical vs. non-ECG-synchronized high-pitch CTA of the aortic root for TAVI planning

et al. 2020

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“…Currently, ACC/ AHA and ESC guidelines on this issue are not available. Recent expert consensus documents, from both cardiological and radiological societies [33,34], recommend CT for procedural planning in the setting of transcatheter aortic valve replacement (TAVR) and valve-in-valve procedures.…”

Section: Transcatheter Procedures and Structural Interventionsmentioning

confidence: 99%

“…5), due to the lack of large randomized trial confirming their value. However, several evidences and specific consensus statements have defined CT and CMR as useful tools to support extra-coronary heart interventions [33,34,48,49].…”

Section: Final Remarksmentioning

confidence: 99%

The current landscape of imaging recommendations in cardiovascular clinical guidelines: toward an imaging-guided precision medicine

et al. 2020

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The purpose of this article is to provide an overview on the role of CT scan and MRI according to selected guidelines by the European Society of Cardiology (ESC) and the American College of Cardiology/American Heart Association (ACC/AHA). ESC and ACC/AHA guidelines were systematically reviewed for recommendations to CT and MRI use in specific cardiovascular (CV) clinical categories. All recommendations were collected in a dataset, including the class of recommendation, the level of evidence (LOE), the specific imaging technique, the clinical purpose of the recommendation and the recommending Society. Among the 43 included guidelines (ESC: n = 18, ACC/AHA: n = 25), 26 (60.4%) contained recommendations for CT scan or MRI (146 recommendations: 62 for CT and 84 for MRI). Class of recommendation IIa (32.9%) was the most represented, followed by I (28.1%), IIb (24%) and III (11.9%). MRI recommendations more frequently being of higher class (I: 36.9%, IIa: 29.8%, IIb: 21.4%, III: 11.9%) as compared to CT (I: 16.1%, IIa: 37.1%, IIb: 27.4%, III: 19.4%). Most of recommendation (55.5%) were based on expert opinion (LOE C). The use of cardiac CT and cardiac MR in the risk assessment, diagnosis, therapeutic and procedural planning is in continuous development, driven by an increasing need to evolve toward an imaging-guided precision medicine, combined with cost-effectiveness and healthcare sustainability. These developments must be accompanied by an increased availability of high-performance scanners in healthcare facilities and should emphasize the need of increasing the number of radiologists fully trained in cardiac imaging.

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The Role of Multimodality Cardiovascular Imaging

Renella

Lai

Prakash

2021

Echocardiography in Pediatric and Congenital Heart Disease

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Computed Tomography Imaging in the Context of Transcatheter Aortic Valve Implantation (TAVI)/Transcatheter Aortic Valve Replacement (TAVR)

Cited by 334 publications

References 96 publications

Retrospectively ECG-gated helical vs. non-ECG-synchronized high-pitch CTA of the aortic root for TAVI planning

Retrospectively ECG-gated helical vs. non-ECG-synchronized high-pitch CTA of the aortic root for TAVI planning

The current landscape of imaging recommendations in cardiovascular clinical guidelines: toward an imaging-guided precision medicine

The Role of Multimodality Cardiovascular Imaging

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