Vascular Imaging Before Transcatheter Aortic Valve Replacement (TAVR): Why and How?

Curr Cardiol Rep. 2016 Feb;18(2):14. doi: 10.1007/s11886-015-0694-5.

Abstract

Transcatheter aortic valve replacement (TAVR) has become an alternative to surgical intervention for symptomatic or severe aortic valve stenosis in patients with high surgical risk. Successful TAVR requires a multimodality imaging approach for appropriate patient selection and prosthesis sizing. Here, we describe individual imaging modalities and report their respective roles in this emerging field. To date, echocardiography remains the traditional test for determining patient candidacy and prosthesis selection, but computed tomography (CT) has been taking on an increasingly important role in the evaluation of both the aortic root anatomy and aortoiliofemoral vessels as a single examination. Cardiac magnetic resonance (CMR) is useful in grading the severity of aortic stenosis and should be considered a reasonable alternative to CT for the evaluation of the aortic annulus, e.g., when the administration of contrast media is contraindicated.

Keywords: Aortic stenosis; Cardiac magnetic resonance; Computed tomography; Echocardiography; Transcatheter aortic valve implantation; Transcatheter aortic valve replacement.

Publication types

  • Review

MeSH terms

  • Aortic Valve / anatomy & histology
  • Aortic Valve / pathology*
  • Aortic Valve Stenosis / diagnosis*
  • Aortic Valve Stenosis / surgery
  • Cardiac Catheterization
  • Contrast Media
  • Echocardiography*
  • Humans
  • Magnetic Resonance Imaging*
  • Multimodal Imaging* / methods
  • Tomography, X-Ray Computed*
  • Transcatheter Aortic Valve Replacement* / methods

Substances

  • Contrast Media