Computed Tomographic Assessment before Transcatheter Aortic and Mitral Valve Replacement

Abstract

Transcatheter aortic valve replacement (TAVR) and transcatheter mitral valve replacement (TMVR) are catheter-based interventional techniques for treating patients having high risk for surgical aortic or mitral valve replacement, respectively. While TAVR is a technique for treating severe aortic stenosis, TMVR is primarily used for treating mitral regurgitation. Echocardiography is the initial imaging modality used for a detailed assessment of the mitral and aortic valve lesions. Multidetector computed tomography (MDCT) is then used as a complementary tool to provide additional information essential for pre-procedure planning. High spatial resolution and good temporal resolution of MDCT along with multiplanar reconstruction technique permit a comprehensive assessment relevant for the multiple aspects of preprocedural planning. The current article outlines the MDCT acquisition protocols, reconstruction techniques, and assessment of various essential parameters for TAVR and TMVR.

Keywords

• cardiac imaging
• neo-left ventricular outflow tract
• structural heart disease interventions