Figure - available from: Current Radiology Reports
This content is subject to copyright. Terms and conditions apply.
Source publication
Purpose of Review
The aim of this article is to review the role of imaging in pre-procedural assessment prior to transcatheter aortic valve replacement (TAVR)—with a focus on relevant anatomic findings apart from the size of the aortic annulus.
Recent Findings
Pre-procedure imaging prior to TAVR heavily emphasizes assessment of the aortic annulus...
Similar publications
Transcatheter aortic valve replacement (TAVR) is widely performed in patients with severe aortic stenosis (AS), having a high surgical risk. However, reports of TAVR performed in patients with anomalous coronary arteries are rare. In existing literature, several complications including coronary obstruction are reported. In this study, we report a 7...
Citations
... However, TAVI started only in 2020 and overlapped with the COVID-19 pandemic (2020-2021) and the russian-Ukrainian war (from February 2022), which explained the small number of patients. The main ideas for senile aortic valve stenosis management we would like to point out are: TAVI or SAVR are both options for surgical treatment [2]; successful outcomes for intervention are based on adequate preoperative planning [10]. ...
Background. Aortic valve stenosis remains the most dominant form of valvular heart disease. The aortic valve area below 1.0 cm2 is an assignment to the interventions. The modern senile aortic valve stenosis treatment options are mini-surgical valve replacement (mini-SVR), balloon aortic valvuloplasty (BAV), and transcatheter aortic valve implantation (TAVI). This study aims to inform readers about up-to-date interventions for patients with senile calcific aortic valve stenosis in Ukraine, based on the experience of the Cardiac surgery department in Lviv, Ukraine. Methods. From a single-centre retrospective registry (10/2015-02/2022), 204 patients were included. One hundred seven patients underwent mini-SVR, tree BAV, and four – TAVI. Diagnostic modalities used to assess the anatomy of the aortic valve were: ECHO, ECG-gated computer tomography with aortic valve calcic scoring, and Angiography. Interventional procedure techniques were BAV, TAVI; surgical: mini-SVR via upper ministernotomy or right-sided minithoracotomy. Results. Anatomical assessment of the aortic valve in senile aortic valve stenosis was based on the morphology of the aortic valve (bicuspid or tricuspid aortic valve), asymmetrical hypertrophy of the left ventricular outflow tract, and coronary ostia height. The age-related anatomical features were calcium deposits in the leaflet, coronary ostium and mitral annular calcification. Ministernotomy (in 67 cases) and a right-sided minithoracotomy (in 40 cases) were performed to secure the “heart step” without instability of the chest cage with the smaller valve size implantation than was expected before. Preserving the chest cage and avoiding aortic cross-clamp/cardio-pulmonary bypass were advantages of TAVI. Fragile patients expected TAVI risks: aortic root damage, paravalvular leak, moderate aortic insufficient, the risk of atrioventricular block and embolic stroke, and kidney dysfunction. Conclusions. Mini-surgical valve replacement and transcatheter aortic valve implantation are accessible procedures in Ukraine for senile calcific aortic valve stenosis treatment.
Rationale and objectives:
Aortic stenosis (AS) is one of the most common valvular heart disease. Symptomatic AS is associated with a high mortality rate which prompts fast intervention. The introduction of transcatheter aortic valve replacement (TAVR) has drastically improved the outcome of high surgical risk for mortality patients with severe AS. However, this procedure requires the employment of multimodality imaging in the pre-procedural planning, intra-procedural optimization, and post-procedural follow-up stages. This also requires an accurate understanding of the indications, measurements, strength, and limitations of each imaging modality during the different TAVR stages.
Conclusion:
In this review, we aim to outline to radiologists the evidence-based approach and indications of different imaging modalities through the pre, peri, and post TAVR stages.
