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CT support of cardiac structural interventions.

Michaela M Hell1, Stephan Achenbach1

  • 1Department of Cardiology, Faculty of Medicine, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU) , Erlangen , Germany.

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|March 12, 2019
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Summary
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Computed tomography (CT) is crucial for pre-procedural imaging in structural heart interventions. It precisely measures cardiac structures, guides access routes, and optimizes device placement for procedures like TAVI and mitral valve interventions.

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Area of Science:

  • Cardiovascular Imaging
  • Interventional Cardiology
  • Medical Imaging Technology

Background:

  • Computed tomography (CT) offers high temporal and isotropic spatial resolution, making it essential for pre-procedural imaging in structural heart disease interventions.
  • Accurate anatomical assessment is critical for the success of minimally invasive cardiac procedures.

Purpose of the Study:

  • To review current methods and applications of pre-interventional CT in adult cardiac interventions.
  • To highlight CT's role in optimizing device selection and procedural planning.

Main Methods:

  • Review of existing literature and clinical practices.
  • Analysis of CT's capabilities in measuring cardiac structures and planning access routes.
  • Evaluation of volumetric CT data for fluoroscopic projection angulation guidance.

Main Results:

  • CT enables precise measurement of target structures for interventions.
  • CT provides vital information on optimal access routes.
  • Volumetric CT data aids in determining ideal fluoroscopic views for device deployment.

Conclusions:

  • Pre-interventional CT is indispensable for guiding various adult cardiac interventions.
  • CT supports procedures such as transcatheter aortic valve implantation, percutaneous mitral valve intervention, left atrial appendage occlusion, and paravalvular leak closure.