Utility of computed tomography in cases of aortic valve stenosis before and after transcatheter aortic valve implantation
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Trans-catheter aortic valve implantation (TAVI) has been recognized as a useful treatment for patients with severe aortic valve stenosis, particularly those with moderate to high risks of open heart surgery. A thorough evaluation of the aortic valve complex, including the size or presence of calcifications of the leaflets and annulus, is important for the selection of appropriate candidates, artificial valve types and approach. Echocardiography is useful for the precise evaluation of aortic valve stenosis severity and aortic valve complex morphology, but it is not useful to evaluate three-dimensional aortic valve anatomy and pathway for the catheter of aortic valve implantation. Electrocardiography (ECG)-gating computed tomography (CT) has recently been recognized as a useful modality for evaluating significant coronary artery stenosis because of its higher spatial and temporal resolution and diagnostic accuracy based on recent studies. ECG-gating CT is also useful for evaluating aortic valve complex morphology, including calcifications and whole aorta and iliac arteries, as the access route of catheter in TAVI. TAVI candidates, who are at high risk of open surgery, tend to be old and require anti-platelet after TAVI; therefore CT, is also useful for screening for non-cardiac diseases including malignant tumors just before TAVI. Therefore, here we introduce the utility of cardiac and whole body CT in cases of severe aortic valve stenosis before and after TAVI.
KeywordsTranscatheter aortic valve implantation Computed tomography Aortic valve stenosis
We would like to express our sincere thanks to Mr. Shusuke Chino and Mr. Masaaki Adachi from Ziosoft for their help and assistance in the analysis of the CT strain data. The authors of this manuscript certify that they complied with the principles of ethical publishing of the Cardiovascular Intervention and Therapeutics. This work was partially supported by the Tsuchiya Memorial Medical Foundation (Grant no. J17KF00167).
HT wrote the first draft of the manuscript and prepared the figures. The other authors reviewed and edited the full report.
Compliance with ethical standards
Conflict of interest
The authors declare no conflicts of interest, either financial or non-financial, regarding this article.
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