Cardiovasc Imaging Asia.  2018 Jul;2(3):110-122. 10.22468/cvia.2018.00129.

Updates on Transcatheter Aortic Valve Replacement and the Role of Multi-Detector Computed Tomography: What a Radiologist Should Know

Affiliations
  • 1Department of Radiology, Cathay General Hospital, Taipei, Taiwan
  • 2Department of Radiology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
  • 3Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei, Taiwan
  • 4Department of Radiology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
  • 5Faculty of Medicine, School of Medicine, National Yang Ming University, Taipei, Taiwan

Abstract

The indications of the transcatheter aortic valve replacement (TAVR) procedure have been widely expanded and the number of cases has significantly increased in the past 15 years due to continued evolution of prosthetic devices, increased experience of cardiologists, and advancements in the cardiovascular imaging field. In this review article, we summarize updates on TAVR guidelines, state-of-the-art prosthetic devices, recommended pre- and post-procedural multi-detector computed tomography (MDCT) protocols, required imaging parameters and measurements, and post-procedural complications. We also address issues concerning the Asian population and patients with bicuspid aortic valve and emphasize some of the challenges ahead. MDCT is the recommended modality of choice for pre-procedural planning for TAVR and current guidelines state that MDCT should be performed by well-trained personnel and interpreted and analyzed by experienced radiologists who not only have a sound understanding of TAVR with respect to its indications, prosthetic devices, procedure, and complications, but also work in close collaboration with the Heart Team.

Keyword

Transcatheter aortic valve replacement; Multidetector computed tomography; Aortic valve stenosis; Aortic dissection
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