CT in Transcatheter-delivered Treatment of Valvular Heart Disease

Radiology. 2022 Jul;304(1):4-17. doi: 10.1148/radiol.210567. Epub 2022 May 31.

Abstract

Minimally invasive strategies to treat valvular heart disease have emerged over the past 2 decades. The use of transcatheter aortic valve replacement in the treatment of severe aortic stenosis, for example, has recently expanded from high- to low-risk patients and became an alternative treatment for those with prohibitive surgical risk. With the increase in transcatheter strategies, multimodality imaging, including echocardiography, CT, fluoroscopy, and cardiac MRI, are used. Strategies for preprocedural imaging strategies vary depending on the targeted valve. Herein, an overview of preprocedural imaging strategies and their postprocessing approaches is provided, with a focus on CT. Transcatheter aortic valve replacement is reviewed, as well as less established minimally invasive treatments of the mitral and tricuspid valves. In addition, device-specific details and the goals of CT imaging are discussed. Future imaging developments, such as peri-procedural fusion imaging, machine learning for image processing, and mixed reality applications, are presented.

Publication types

  • Review

MeSH terms

  • Aortic Valve / diagnostic imaging
  • Aortic Valve Stenosis* / diagnostic imaging
  • Aortic Valve Stenosis* / surgery
  • Cardiac Catheterization
  • Echocardiography
  • Heart Valve Diseases* / diagnostic imaging
  • Heart Valve Diseases* / surgery
  • Heart Valve Prosthesis Implantation* / methods
  • Humans
  • Multimodal Imaging
  • Tomography, X-Ray Computed / methods
  • Transcatheter Aortic Valve Replacement*