Duran Cihan, Masood Irfan, Duran Alper, Frank Luba, Saleem Arsalan, Muthupillai Raja, Cheong Benjamin Y C
Department of Radiology, University of Texas Medical Branch (UTMB) at Galveston, Texas, USA.
Departments of Radiology, Texas Heart Institute at CHI St. Luke's Health-Baylor Medical Center, Texas, USA.
Eurasian J Med. 2020 Feb;52(1):86-93. doi: 10.5152/eurasianjmed.2019.18329.
Transcatheter aortic valve replacement (TAVR) initially emerged as an alternative option to surgical aortic valve replacement (SAVR) for patients with severe aortic stenosis who were considered either inoperable or high-risk for surgery. However, since its advent the role of TAVR has been continuously evolving on the basis of clinical trials which showed that TAVR is non-inferior to SAVR in patients with moderate as well as low-risk for surgery. Because of recent technological advances, multidetector computer tomography (MDCT) is inherently suitable for the pre-procedural assessment of patients being considered for TAVR within a very short imaging time, MDCT can measure the diameter of the aortic annulus, provide detailed information regarding 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 pre-procedural decisions and avoid complications. To familiarize non-imaging specialists with the role of MDCT in TAVR, we provide a concise overview of our approach to using this modality for the pre-procedural assessment of TAVR candidates.
经导管主动脉瓣置换术（TAVR）最初是作为外科主动脉瓣置换术（SAVR）的替代选择出现的，适用于那些被认为无法进行手术或手术风险高的严重主动脉瓣狭窄患者。然而，自其出现以来，TAVR的作用一直在不断演变，临床试验表明，在中度以及低手术风险的患者中，TAVR不劣于SAVR。由于最近的技术进步，多排螺旋计算机断层扫描（MDCT）在极短的成像时间内天生就适合对考虑进行TAVR的患者进行术前评估，MDCT可以测量主动脉瓣环的直径，提供有关整个胸腹主动脉状况的详细信息，并评估用于经导管心脏瓣膜输送的外周血管的口径。这些信息有助于介入医生做出最佳的术前决策并避免并发症。为了使非影像专家熟悉MDCT在TAVR中的作用，我们简要概述了我们使用这种方式对TAVR候选者进行术前评估的方法。
