Contrast-enhanced computed tomographic imaging provides detailed 3-dimensional anatomical assessment of the aortic root, complementing echocardiography for presurgical planning of valvar repair.
Does contrast-enhanced computed tomographic imaging improve presurgical planning for aortic valve repair?
Contrast-enhanced CT imaging with 3D reconstruction provides valuable anatomical insights that complement echocardiography for planning customized aortic valve repairs.
There is continued interest in surgical repair of both the congenitally malformed aortic valve, and the valve with acquired dysfunction. Aortic valvar repair based on a geometric approach has demonstrated improved durability and outcomes. Such an approach requires a thorough comprehension of the complex 3-dimensional anatomy of both the normal and congenitally malformed aortic root. In this review, we provide an understanding of this anatomy based on the features that can accurately be revealed by contrast-enhanced computed tomographic imaging. We highlight the complimentary role that such imaging, with multiplanar reformatting and 3-dimensional reconstructions, can play in selection of patients, and subsequent presurgical planning for valvar repair. The technique compliments other established techniques for perioperative imaging, with echocardiography maintaining its central role in assessment, and enhances direct surgical evaluation. This additive morphological and functional information holds the potential for improving selection of patients, surgical planning, subsequent surgical repair, and hopefully the subsequent outcomes.
Tretter et al. (Mon,) conducted a review in Congenitally malformed or acquired dysfunction of the aortic valve. Contrast-enhanced computed tomographic imaging was evaluated. Contrast-enhanced computed tomographic imaging provides detailed 3-dimensional anatomical assessment of the aortic root, complementing echocardiography for presurgical planning of valvar repair.