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Cardiac
Intervention
Interventional and Electrophysiological Procedures
Transcatheter Aortic Valve Replacement: Procedure Planning
Transcatheter Aortic Valve Replacement: Procedure Planning
Marcelo Godoy Zamorano, MD, MSc; Jonathon Leipsic, MD, FRCPC, FSCCT
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KEY FACTS

  • Terminology

    • Imaging Anatomy

      • Anatomy Imaging Issues

        • Pathology Issues

          • Clinical Implications

            TERMINOLOGY

            • Abbreviations

              • Transcatheter aortic valve replacement (TAVR)

            • Synonyms

              • Transcatheter aortic valve implantation (TAVI)
              • Percutaneous aortic valve replacement

            • Definitions

              • TAVR is percutaneous deployment of bioprosthetic valve in aortic root
                • Endovascular access point for delivery of valve is commonly femoral artery; however, other options include left ventricular transapical approach
                • It is treatment of choice for patients with aortic stenosis at high or intermediate surgical risk and as alternative for those at low surgical risk

            IMAGING ANATOMY

            • General Anatomic Considerations

              • Critical Anatomic Structures

                • Imaging Recommendations

                  CLINICAL IMPLICATIONS

                  • Clinical Importance

                    Selected References

                    1. Wilson R et al: Transcatheter aortic and mitral valve replacements. Radiol Clin North Am. 57(1):165-78, 2019
                    2. Akinseye OA et al: Clinical outcomes of coronary occlusion following transcatheter aortic valve replacement: A systematic review. Cardiovasc Revasc Med. 19(2):229-36, 2018
                    3. Blanke P et al: Valvular Diseases and Interventions. In Budoff M et al: Atlas of Cardiovascular Computed Tomography. 2nd ed. New York: Springer, 2018
                    4. Herrmann HC et al: Prosthesis-patient mismatch in patients undergoing transcatheter aortic valve replacement: from the STS/ACC TVT registry. J Am Coll Cardiol. 72(22):2701-11, 2018
                    5. Pollari F et al: Risk factors for paravalvular leak after transcatheter aortic valve replacement. J Thorac Cardiovasc Surg. ePub, 2018
                    6. Expert Panel on Cardiac imaging and vascular imaging:. et al: ACR Appropriateness Criteria® Imaging for Transcatheter Aortic Valve Replacement. J Am Coll Radiol. 14(11S):S449-55, 2017
                    7. Hell MM et al: Prediction of fluoroscopic angulations for transcatheter aortic valve implantation by CT angiography: influence on procedural parameters. Eur Heart J Cardiovasc Imaging. 18(8):906-14, 2017
                    8. Rodriguez-Gabella T et al: Aortic bioprosthetic valve durability: incidence, mechanisms, predictors, and management of surgical and transcatheter valve degeneration. J Am Coll Cardiol. 70(8):1013-28, 2017
                    9. Soon J et al: Multimodality imaging for planning and follow-up of transcatheter aortic valve replacement. Can J Cardiol. 33(9):1110-23, 2017
                    10. Pasic M et al: Annular rupture during transcatheter aortic valve replacement: classification, pathophysiology, diagnostics, treatment approaches, and prevention. JACC Cardiovasc Interv. 8(1 Pt A):1-9, 2015
                    11. Salgado RA et al: Preprocedural CT evaluation of transcatheter aortic valve replacement: what the radiologist needs to know-erratum. Radiographics. 35(1):299, 2015
                    12. Athappan G et al: Incidence, predictors, and outcomes of aortic regurgitation after transcatheter aortic valve replacement: meta-analysis and systematic review of literature. J Am Coll Cardiol. 61(15):1585-95, 2013
                    13. Blanke P et al: CT in transcatheter aortic valve replacement. Radiology. 269(3):650-69, 2013
                    14. Ribeiro HB et al: Coronary obstruction following transcatheter aortic valve implantation: a systematic review. JACC Cardiovasc Interv. 6(5):452-61, 2013
                    15. Binder RK et al: Prediction of optimal deployment projection for transcatheter aortic valve replacement: angiographic 3-dimensional reconstruction of the aortic root versus multidetector computed tomography. Circ Cardiovasc Interv. 5(2):247-52, 2012
                    Related Anatomy
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                    References
                    Tables

                    Tables

                    KEY FACTS

                    • Terminology

                      • Imaging Anatomy

                        • Anatomy Imaging Issues

                          • Pathology Issues

                            • Clinical Implications

                              TERMINOLOGY

                              • Abbreviations

                                • Transcatheter aortic valve replacement (TAVR)

                              • Synonyms

                                • Transcatheter aortic valve implantation (TAVI)
                                • Percutaneous aortic valve replacement

                              • Definitions

                                • TAVR is percutaneous deployment of bioprosthetic valve in aortic root
                                  • Endovascular access point for delivery of valve is commonly femoral artery; however, other options include left ventricular transapical approach
                                  • It is treatment of choice for patients with aortic stenosis at high or intermediate surgical risk and as alternative for those at low surgical risk

                              IMAGING ANATOMY

                              • General Anatomic Considerations

                                • Critical Anatomic Structures

                                  • Imaging Recommendations

                                    CLINICAL IMPLICATIONS

                                    • Clinical Importance

                                      Selected References

                                      1. Wilson R et al: Transcatheter aortic and mitral valve replacements. Radiol Clin North Am. 57(1):165-78, 2019
                                      2. Akinseye OA et al: Clinical outcomes of coronary occlusion following transcatheter aortic valve replacement: A systematic review. Cardiovasc Revasc Med. 19(2):229-36, 2018
                                      3. Blanke P et al: Valvular Diseases and Interventions. In Budoff M et al: Atlas of Cardiovascular Computed Tomography. 2nd ed. New York: Springer, 2018
                                      4. Herrmann HC et al: Prosthesis-patient mismatch in patients undergoing transcatheter aortic valve replacement: from the STS/ACC TVT registry. J Am Coll Cardiol. 72(22):2701-11, 2018
                                      5. Pollari F et al: Risk factors for paravalvular leak after transcatheter aortic valve replacement. J Thorac Cardiovasc Surg. ePub, 2018
                                      6. Expert Panel on Cardiac imaging and vascular imaging:. et al: ACR Appropriateness Criteria® Imaging for Transcatheter Aortic Valve Replacement. J Am Coll Radiol. 14(11S):S449-55, 2017
                                      7. Hell MM et al: Prediction of fluoroscopic angulations for transcatheter aortic valve implantation by CT angiography: influence on procedural parameters. Eur Heart J Cardiovasc Imaging. 18(8):906-14, 2017
                                      8. Rodriguez-Gabella T et al: Aortic bioprosthetic valve durability: incidence, mechanisms, predictors, and management of surgical and transcatheter valve degeneration. J Am Coll Cardiol. 70(8):1013-28, 2017
                                      9. Soon J et al: Multimodality imaging for planning and follow-up of transcatheter aortic valve replacement. Can J Cardiol. 33(9):1110-23, 2017
                                      10. Pasic M et al: Annular rupture during transcatheter aortic valve replacement: classification, pathophysiology, diagnostics, treatment approaches, and prevention. JACC Cardiovasc Interv. 8(1 Pt A):1-9, 2015
                                      11. Salgado RA et al: Preprocedural CT evaluation of transcatheter aortic valve replacement: what the radiologist needs to know-erratum. Radiographics. 35(1):299, 2015
                                      12. Athappan G et al: Incidence, predictors, and outcomes of aortic regurgitation after transcatheter aortic valve replacement: meta-analysis and systematic review of literature. J Am Coll Cardiol. 61(15):1585-95, 2013
                                      13. Blanke P et al: CT in transcatheter aortic valve replacement. Radiology. 269(3):650-69, 2013
                                      14. Ribeiro HB et al: Coronary obstruction following transcatheter aortic valve implantation: a systematic review. JACC Cardiovasc Interv. 6(5):452-61, 2013
                                      15. Binder RK et al: Prediction of optimal deployment projection for transcatheter aortic valve replacement: angiographic 3-dimensional reconstruction of the aortic root versus multidetector computed tomography. Circ Cardiovasc Interv. 5(2):247-52, 2012