Lorenzatti Daniel, Filtz Annalisa, Geers Jolien, Grodecki Kajetan, Jaspan Vita, Pierce Colin, Miller Matthew J, Park Christine, Danilov Alexandrina, Blankstein Ron, Treibel Thomas A, Cavalcante João L, Shaw Leslee J, Dweck Marc R, Slomka Piotr J, Dey Damini, Slipczuk Leandro
Montefiore Health System/Albert Einstein College of Medicine, Bronx, NY, USA.
Montefiore Health System/Albert Einstein College of Medicine, Bronx, NY, USA; RCCS Ospedale Ca' Granda Maggiore Policlinico, Universita' degli Studi di Milano, Milan, Italy.
J Cardiovasc Comput Tomogr. 2025 Feb 5. doi: 10.1016/j.jcct.2025.01.008.
In an era of rapidly expanding use of transcatheter aortic valve replacement (TAVR), cardiovascular computed tomography (CCT) has become an essential component in the evaluation process for the growing number of patients. Because of the nature of the guideline-recommended protocol -involving several different CCT acquisitions-it represents a unique dataset for comprehensive phenotyping of the patient with significant aortic stenosis. A substantial body of data has established CCT as a central tool in pre-procedural implantation planning. However, emerging evidence suggests a potential new role for CCT in phenotyping patient risk beyond the index procedure. This new role could represent a unique opportunity in patient selection, medication optimization and follow up post TAVR aiming to improve long-term prognosis. This review highlights emerging data on CCT imaging features for risk stratification in patients during long-term follow-up after TAVR. We summarize the existing literature on this topic and explore whether comprehensive CCT-derived information could be integrated into clinical practice, potentially enhancing TAVR patient selection and post-procedural care.
在经导管主动脉瓣置换术（TAVR）使用迅速增加的时代，心血管计算机断层扫描（CCT）已成为越来越多患者评估过程中的重要组成部分。由于指南推荐方案的性质——涉及几种不同的CCT采集——它代表了一个用于对重度主动脉瓣狭窄患者进行全面表型分析的独特数据集。大量数据已将CCT确立为术前植入计划的核心工具。然而，新出现的证据表明CCT在表型分析患者超出索引手术的风险方面可能具有新作用。这一新作用可能在患者选择、药物优化和TAVR术后随访中代表一个独特机会，旨在改善长期预后。本综述重点介绍了TAVR术后长期随访期间CCT成像特征用于患者风险分层的新出现数据。我们总结了关于该主题的现有文献，并探讨全面的CCT衍生信息是否可以整合到临床实践中，从而潜在地改善TAVR患者的选择和术后护理。
