The role of multimodality imaging in the selection of patients for aortic valve repair

Expert Rev Cardiovasc Ther. 2016;14(1):75-86. doi: 10.1586/14779072.2016.1109448. Epub 2015 Nov 4.

Abstract

Aortic valve sparing surgery for aortic regurgitation and/or aortopathy serves as an alternative to aortic valve and root replacement. One of the advantages of aortic valve sparing surgery over conventional replacement is that there is no need for life-long anticoagulation, which is particularly attractive in young patients who may receive a mechanical prosthesis otherwise. However, successful aortic valve repair requires high expertise. At present, reparability is determined intraoperatively by direct surgical inspection. Preoperative imaging techniques might improve the patient selection for aortic valve repair. The mechanism of aortic regurgitation, aortic valve morphology and calcification and aortic root dimensions are all of importance when aortic valve repair is considered. The present review focuses on the role of imaging techniques in determining aortic valve reparability.

Keywords: 3-dimensional echocardiography; aortic regurgitation; aortic root aneurysm; aortic valve repair; cardiac magnetic resonance; multi-detector row computed tomography.

Publication types

  • Review

MeSH terms

  • Aortic Valve* / pathology
  • Aortic Valve* / physiopathology
  • Aortic Valve* / surgery
  • Bicuspid Aortic Valve Disease
  • Cardiac Imaging Techniques / methods*
  • Cardiac Surgical Procedures* / adverse effects
  • Cardiac Surgical Procedures* / methods
  • Heart Defects, Congenital* / diagnosis
  • Heart Defects, Congenital* / physiopathology
  • Heart Defects, Congenital* / surgery
  • Heart Valve Diseases* / diagnosis
  • Heart Valve Diseases* / physiopathology
  • Heart Valve Diseases* / surgery
  • Humans
  • Intraoperative Care / methods
  • Multimodal Imaging / methods*
  • Patient Selection
  • Postoperative Complications / prevention & control*
  • Preoperative Care / methods