Key result
Multimodality imaging using echocardiography and CT angiography is crucial for pre-operative management, peri-procedural guidance, and follow-up in patients undergoing transcatheter aortic valve implantation.
Multimodality imaging, particularly MSCT and echocardiography, is essential for the safe and effective planning, guidance, and follow-up of TAVI procedures.
CT angiography may improve pre-TAVI anatomic assessment; leaves open optimal multimodality imaging protocols.
The transcatheter aortic valve implantation (TAVI) consist an alternative treatment in patients with severe aortic stenosis. Multimodality imaging using transthoracic echocardiography (TTE) or transesophageal echocardiography (TOE) and multislice CT (MSCT) constitute cornerstone techniques for the pre-operative management, peri-procedural guidance, follow up and recognition of possible transcatheter valve related complications. CT angiography is much more accurate regarding the total definition of aortic annulus diameter and circumferential area. Two-dimensional (2D) echocardiography, underestimates the aortic valve annulus diameter compared to 3D imaging techniques (MSCT, MRI and 3D TOE). Three-dimensional TOE imaging provides measurements of the aortic valve annulus similar to those delivered by MSCT. The pre-procedural MSCT constitutes the gold standard modality minimizing the presence of paravalvular aortic regurgitation, one of the most frequent complications. TOE/TTE and MSCT performance could predict the possibility of pacemaker implantation post-procedural. The presence of a new transient or persisting MR can be assessed well by TOE. Both TTE and TOE, consist initially the basic examination for post TAVI evaluation. In case of transcatheter heart valve failure, the MSCT could be used as additional imaging technique.
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Chourdakis et al. (2018) conducted a review in Severe aortic stenosis. Echocardiography and CT angiography was evaluated. Multimodality imaging using echocardiography and CT angiography is crucial for pre-operative management, peri-procedural guidance, and follow-up in patients undergoing transcatheter aortic valve implantation.
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