Cardiac Computed Tomography and Computed Tomography Angiography in the Evaluation of Patients Prior to Transcatheter Aortic Valve Implantation

PURPOSE OF REVIEW:

Advancements in the use of multidetector computed tomography (CT) in transcatheter aortic valve implantation/transcatheter aortic valve replacement (TAVI/TAVR) over the last year reaffirm its role in the evaluation of preprocedural planning and procedural guidance. The purpose of this review is to provide an up-to-date review of recently published data, with a particular focus on annular sizing and transcatheter heart valve selection to help reduce paravalvular regurgitation.

RECENT FINDINGS:

Recent data have confirmed that multidetector computed tomography (MDCT) measures of the annulus are highly reproducible across multiple readers and workstation platforms. MDCT has also been shown to have a strong discriminatory ability to predict and reduce postprocedural paravalvular regurgitation (PAR), as well as presenting the current data for integrating CT measures of the annulus into sizing.

SUMMARY:

Over the last year, MDCT has solidified itself as an essential tool for the evaluation of the aortic root and annulus prior to TAVI. MDCT annular measurements are highly reproducible and now form the basis for transcatheter heart valve selection, with early data suggesting that CT integration can reduce paravalvular regurgitation.