Multidetector Computed Tomography (MDCT) Angiography in the Pre-Procedural Assessment of Patients Undergoing Transcatheter Aortic Valve Replacement

Abstract

Transcatheter aortic valve replacement (TAVR) initially emerged as an alternative option to surgical aorticvalve replacement (SAVR) for patients with severe aortic stenosis who were considered either inoperable orhigh-risk for surgery. However, since its advent the role of TAVR has been continuously evolving on the basisof clinical trials which showed that TAVR is non-inferior to SAVR in patients with moderate as well as lowrisk for surgery. Because of recent technological advances, multidetector computer tomography (MDCT) isinherently suitable for the pre-procedural assessment of patients being considered for TAVR within a veryshort imaging time, MDCT can measure the diameter of the aortic annulus, provide detailed informationregarding the status of the entire thoracoabdominal aorta, and assess the caliber of the peripheral vasculature used for transcatheter heart valve delivery. This information helps interventionists make optimal preprocedural decisions and avoid complications. To familiarize non-imaging specialists with the role of MDCTin TAVR, we provide a concise overview of our approach to using this modality for the pre-proceduralassessment of TAVR candidates.