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经导管主动脉瓣置换术患者何时需考虑心血管磁共振?

When to consider cardiovascular magnetic resonance in patients undergoing transcatheter aortic valve replacement?

机构信息

Cardiac Magnetic Resonance Laboratory, Methodist DeBakey Heart and Vascular Center, Houston, Texas 77030, USA.

出版信息

Curr Opin Cardiol. 2013 Sep;28(5):505-11. doi: 10.1097/HCO.0b013e32836245fb.

Abstract

PURPOSE OF REVIEW

To discuss the relevant techniques as well as the recent evidence that enhance the understanding of the reader on the applications of cardiovascular magnetic resonance (CMR) in transcatheter aortic valve replacement (TAVR). With different cardiac imaging modalities available as well as the advent of TAVR, it is important to define when CMR can be helpful in the periprocedural evaluation.

RECENT FINDINGS

The topics of interest covered in this review are CMR evaluation of aortic stenosis/regurgitation, TAVR sizing, vascular measurements for access planning, postimplantation paravalvular regurgitation (PVR), and the potential role of delayed enhancement assessment in patients undergoing TAVR.

SUMMARY

CMR is a complementary modality in the assessment of TAVR candidates. The ability of CMR to assess the hemodynamic significance of aortic stenosis and other valvulopathies, as well as to assess accurately the left ventricular ejection fraction and vascular anatomy, makes this technique well rounded. The roles of delayed enhancement for myocardial scar in the evaluation of TAVR candidates and PVR assessment in the postimplant patient are promising, but still yet to be fully defined.

摘要

目的综述

讨论相关技术以及近期的证据,以增强读者对心血管磁共振(CMR)在经导管主动脉瓣置换术(TAVR)中的应用的理解。随着各种心脏成像方式的出现以及 TAVR 的出现,明确 CMR 在围手术期评估中的作用非常重要。

最近的发现

本综述涵盖的感兴趣的主题包括 CMR 评估主动脉瓣狭窄/反流、TAVR 大小、血管测量以进行入路规划、植入后瓣周漏(PVR)以及接受 TAVR 的患者延迟强化评估的潜在作用。

总结

CMR 是 TAVR 患者评估的一种补充方式。CMR 评估主动脉瓣狭窄和其他瓣膜病的血流动力学意义以及准确评估左心室射血分数和血管解剖结构的能力使该技术具有全面性。延迟强化在 TAVR 患者评估中的作用以及植入后 PVR 评估的作用很有前景,但仍有待充分定义。

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