Tavr

Singh, Satinder P.; Alli, Oluseun; Melby, Spencer J.; Lessar, Massoud; Sasse, Mark; Booker, Julian; Davies, James E.

doi:10.1097/rti.0000000000000175

Journal of Thoracic Imaging

2015

DOI: 10.1097/rti.0000000000000175

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Tavr

Satinder P. Singh

Oluseun Alli

Spencer J. Melby³

et al.

Abstract: Transcatheter aortic valve replacement has recently become a suitable alternative for senile aortic stenosis in patients not suitable for surgery. With growing operative experience, appropriate patient selection, advances in imaging evaluation, and technical refinements, the outcomes have improved. Despite its less invasive nature, a unique set of complications and events are encountered during the transcatheter aortic valve replacement procedure and in the postoperative period. Knowledge of these complication… Show more

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Cited by 3 publications

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The Crucial Role of Cardiac Imaging in Transcatheter Aortic Valve Replacement (TAVR): Pre- and Post-procedural Assessment

Al-Najafi

Sanchez

2016

Curr Treat Options Cardio Med

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Transcatheter valve interventions have emerged as one of the most important developments in structural heart disease over the past 20 years. Initially, these interventions were directed at patients with severe aortic stenosis and high surgical risk; however, their applications have extended to involve other native valves' pathologies, degenerated prosthetic valves, as well as patients of lower surgical risk. In this article, we discuss the importance of cardiac imaging in transcatheter aortic valve replacement (TAVR) by exploring the current practices, guidelines, and recommendations with the supporting data. We believe that the key for a successful TAVR is careful pre-procedural planning and early detection of any possible post-implantation complications. To achieve this, multimodality imaging is cornerstone. Throughout the stages of patient-evaluation, echocardiography and computed tomography play complementary roles. MRI, on the other hand, has emerged as a useful tool in quantifying post-implantation paravalvular regurgitation.

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The Crucial Role of Cardiac Imaging in Transcatheter Aortic Valve Replacement (TAVR): Pre- and Post-procedural Assessment

Al-Najafi

Sanchez

2016

Curr Treat Options Cardio Med

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Acute Thoracic Complications of Minimally Invasive Cardiac Procedures

Weisman

Cheng

Girvin

et al. 2021

Curr Treat Options Cardio Med

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Ferumoxytol-enhanced MR Angiography for Vascular Access Mapping before Transcatheter Aortic Valve Replacement in Patients with Renal Impairment: A Step Toward Patient-specific Care

Nguyen¹,

Moriarty²,

Plotnik³

et al. 2018

Radiology

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Purpose To assess the technical feasibility of the use of ferumoxytol-enhanced (FE) magnetic resonance (MR) angiography for vascular mapping before transcatheter aortic valve replacement in patients with renal impairment. Materials and Methods This was an institutional review board-approved and HIPAA-compliant study. FE MR angiography was performed at 3.0 T or 1.5 T. Unenhanced computed tomographic (CT) images were used to overlay vascular calcification on FE MR angiographic images as composite fused three-dimensional data. Image quality of the subclavian and aortoiliofemoral arterial tree and confidence in the assessment of calcification were evaluated by using a four-point scale (4 = excellent vascular definition or strong confidence). Signal intensity nonuniformity as reflected by the heterogeneity index (ratio between the mean standard deviation of luminal signal intensity and the mean luminal signal intensity), signal-to-noise ratio, and consistency of luminal diameter measurements were quantified. Findings at FE MR angiography were compared with pelvic angiograms. Results Twenty-six patients underwent FE MR angiography without adverse events. A total of 286 named vascular segments were scored. The image quality score was 4 for 99% (283 of 286) of the segments (κ = 0.9). There was moderate to strong confidence in the ability to assess vascular calcific morphology in all studies with complementary unenhanced CT. The steady-state luminal heterogeneity index was low, and signal-to-noise ratio was high. Interobserver luminal measurements were reliable (intraclass correlation coefficient, 0.98; 95% confidence interval: 0.98, 0.99). FE MR angiographic findings were consistent with correlative pelvic angiograms in all 16 patients for whom the latter were available. Conclusion In patients with renal impairment undergoing transcatheter aortic valve replacement, FE MR angiography is technically feasible and offers reliable vascular mapping without exposure to iodine- or gadolinium-based contrast agents. Thus, the total cumulative dose of iodine-based contrast material is minimized and the risk of acute nephropathy is reduced. RSNA, 2017 Online supplemental material is available for this article.

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Tavr

Cited by 3 publications

References 39 publications

The Crucial Role of Cardiac Imaging in Transcatheter Aortic Valve Replacement (TAVR): Pre- and Post-procedural Assessment

The Crucial Role of Cardiac Imaging in Transcatheter Aortic Valve Replacement (TAVR): Pre- and Post-procedural Assessment

Acute Thoracic Complications of Minimally Invasive Cardiac Procedures

Ferumoxytol-enhanced MR Angiography for Vascular Access Mapping before Transcatheter Aortic Valve Replacement in Patients with Renal Impairment: A Step Toward Patient-specific Care

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