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CT in Transcatheter-delivered Treatment of Valvular Heart Disease
Piotr Nikodem Rudzinski1, Jonathon A Leipsic1, U Joseph Schoepf1
1From the Division of Cardiovascular Imaging, Department of Radiology and Radiological Science (P.N.R., U.J.S., J.R.B., T.E., A.V.S.), and Department of Cardiology (N.S.A., D.H.S., R.R.B.), Medical University of South Carolina, 25 Courtenay Dr, MSC 226, Charleston, SC 29425; Department of Coronary and Structural Heart Diseases, National Institute of Cardiology, Warsaw, Poland (P.N.R., M.D., C.K.); Department of Radiology for Providence Health Care, Vancouver Coastal Health, Vancouver, Canada (J.A.L.); Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland (D.D.); Maria Cecilia Hospital, GVM Care & Research, Cotignola (RA), Ravenna, Italy (D.D.); Department of Diagnostic and Interventional Radiology, Universitätsklinikum Augsburg, Augsburg, Germany (F.S.); Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria (M.A.); Department of Measurement and Electronics, AGH University of Science and Technology, Krakow, Poland (A.Z.H.); Department of Cardiology, Medizinische Klinik I, RoMed Klinikum Rosenheim, Rosenheim, Germany (C.T.); Department of Cardiology, Kerckhoff Heart Center, Bad Nauheim, Germany (M.R.); and Department of Radiology, Poznan University of Medical Sciences, Poznan, Poland (P.P.).
Abstract:
Minimally invasive strategies to treat valvular heart disease have emerged over the past 2 decades. The use of transcatheter aortic valve replacement in the treatment of severe aortic stenosis, for example, has recently expanded from high- to low-risk patients and became an alternative treatment for those with prohibitive surgical risk. With the increase in transcatheter strategies, multimodality imaging, including echocardiography, CT, fluoroscopy, and cardiac MRI, are used. Strategies for preprocedural imaging strategies vary depending on the targeted valve. Herein, an overview of preprocedural imaging strategies and their postprocessing approaches is provided, with a focus on CT. Transcatheter aortic valve replacement is reviewed, as well as less established minimally invasive treatments of the mitral and tricuspid valves. In addition, device-specific details and the goals of CT imaging are discussed. Future imaging developments, such as peri-procedural fusion imaging, machine learning for image processing, and mixed reality applications, are presented.
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