Feasibility and accuracy of a comprehensive multidetector computed tomography acquisition for patients referred for balloon-expandable transcatheter aortic valve implantation

Diagnostic accuracy of computed tomography angiography for the detection of coronary artery disease in patients referred for transcatheter aortic valve implantation

“…Further, it should be noted that patients with aortic stenosis undergoing conventional open heart surgery have significantly fewer comorbidities, including lower prevalence of CAD, compared with the high-risk TAVI population, which might further contribute to reduced CTA feasibility and diagnostic performance in the latter. In the only study assessing the diagnostic accuracy of a standardized CTA for the detection of significant CAD in 60 highly selected TAVI candidates, Pontone et al [5] reported a feasibility of 87 % with sensitivity, specificity, and NPV of 88, 88, and 91 %, respectively. In our study, the feasibility of CTA was 53 % with the per-patient sensitivity, specificity, and NPV of 98, 37, and 94 %, respectively.…”

“…Currently, invasive coronary angiography (ICA) remains the gold standard diagnostic modality for the detection of significant CAD in patients scheduled for TAVI; however, it still carries a non-negligible risk for catheter-related complications as well as increased contrast dye use, both of which should be of special concern in the frail TAVI population. Until now, there is very limited data on the potential application of pre-procedural CTA for the detection of CAD before TAVI [5]. We, thus, retrospectively investigated the diagnostic accuracy of a standardized CTA for the identification of significant CAD as compared with the reference ICA in a large cohort of patients referred for TAVI at a single, highvolume institution.…”

Incidence and severity of atherosclerotic cardiovascular artery disease in patients undergoing TAVI

“…All patients received a tripleinjection protocol of an 80-mL bolus of contrast (Iomeron 400 mg/mL; Bracco, Milan, Italy) through an antecubital vein at an infusion rate of 5 mL/s, followed by 50 mL of saline solution and an additional 50 of mL contrast bolus at 3.5 mL/s using fluoroscopic trigger method [19]. Exclusion criteria were impaired renal function, rhythm disturbances, inability to sustain a 10-s breath-hold or other technical limitations.…”

A novel contribution towards coherent and reproducible intravalvular measurement of the aortic annulus by multidetector computed tomography ahead of transcatheter aortic valve implantation

“…The definition of the aortic annulus as measured on MDCT is itself indeterminate [4,[8][9][10][11][12] and even measurements taken from the virtual basal ring (VBR) vary greatly [9,10,12]. In five large cohort studies [1,6,9,11,13] (comprising 53, 60, 71, 80 and 109 patients awaiting TAVI, respectively), the mean VBR diameter -reputed to be highly reproducible [8] -ranged from 22.8 mm to 24.5 mm.…”

“…In five large cohort studies [1,6,9,11,13] (comprising 53, 60, 71, 80 and 109 patients awaiting TAVI, respectively), the mean VBR diameter -reputed to be highly reproducible [8] -ranged from 22.8 mm to 24.5 mm. Prosthesis/annulus discrepancy can lead to complications, most commonly mismatch [7,14,15] or paravalvular aortic regurgitation [12,[16][17][18], with a potentially severe effect on morbidity and mortality.…”