Pre - Transcatheter Aortic Valve Implantation Workup in the Cardiac Catheterisation Laboratory

Heart Lung Circ. 2015 Dec;24(12):1162-70. doi: 10.1016/j.hlc.2015.07.018. Epub 2015 Aug 11.

Abstract

Transcatheter aortic valve implantation (TAVI) is a rapidly evolving field with exponential growth worldwide in TAVI numbers. One of the principle methods in improving outcomes with a new technique such as TAVI is to ensure that patients undergo efficient pre-procedural evaluation. Standard TAVI workup includes clinical assessment, surgical and frailty risk scoring, blood investigations, echocardiography, pulmonary function tests, computed tomography (CT) angiography and cardiac catheterisation. Patients sent to the cardiac catheterisation laboratory (CCL) for TAVI workup require a systematic and thorough approach. This can include iliofemoral angiography, aortography, aortic valve crossing, haemodynamic evaluation, coronary angiography and right heart catheterisation. In addition, several key steps are required to evaluate suitability for the percutaneous transfemoral TAVI approach. This is the first review to systematically describe steps to evaluate pre-TAVI patients in the CCL. Due to the rapidly rising TAVI numbers, this workup will likely be performed not only by TAVI operators but also by the general interventional cardiologist.

Keywords: Angiography; Catheterisation; Haemodynamics; Transcatheter aortic valve implantation; Vasculature.

Publication types

  • Review

MeSH terms

  • Angiography / methods*
  • Humans
  • Preoperative Care / methods*
  • Tomography, X-Ray Computed / methods*
  • Transcatheter Aortic Valve Replacement / methods*