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Improved Registration of 3D CT Angiography with X-ray Fluoroscopy for Image Fusion During Transcatheter Aortic Valve Implantation
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Improved Registration of 3D CT Angiography with X-ray Fluoroscopy for Image Fusion During Transcatheter Aortic Valve Implantation

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Multidetector Computer Tomography Angiography Protocol in the Context of Transcatheter Aortic Valve Implantation

Esra Belen1, Huseyin Ozkurt1, Ugur Yanc1

  • 1Seyrantepe Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey.

Sisli Etfal Hastanesi Tip Bulteni
|August 22, 2022
PubMed

Insights

Computed tomography (CT) is vital for transcatheter aortic valve implantation (TAVI) planning. Advanced CT imaging protocols ensure accurate measurements and guide physicians for successful TAVI procedures.

Area of Science:

  • Cardiovascular Imaging
  • Interventional Cardiology
  • Medical Imaging Technology

Background:

  • Transcatheter aortic valve implantation (TAVI) is a critical procedure for patients unsuitable for open-heart surgery.
  • Accurate pre-procedural imaging is essential for TAVI success, particularly for sizing the aortic valve and assessing vascular access.
  • Computed tomography (CT) has become indispensable for detailed anatomical assessment in TAVI.

Purpose of the Study:

  • To highlight the importance of specific CT imaging protocols for TAVI.
  • To detail the critical measurements and image processing techniques required for TAVI planning.
  • To emphasize the role of advanced CT in guiding TAVI procedures.

Main Methods:

  • Utilizing CT scans to measure aortic root width, aortic valve surface area, and the dimensions of the aortic tree and peripheral arteries.
  • Implementing specialized imaging protocols for coronary artery assessment, including curved Multiplanar Reconstruction (MPR) and Volume Rendering Technique (VRT).
  • Employing ECG-triggered scanning (retrospective and prospective) with a minimum 64-slice multi-detector CT (MDCT) scanner and bolus tracking for optimal contrast enhancement.

Main Results:

  • CT-derived measurements accurately determine the appropriate valve size for TAVI.
  • Processed coronary artery images (curved MPR, VRT) provide crucial guidance for physicians during the TAVI procedure.
  • Advanced CT imaging, including bolus tracking and automatic dose calibration, ensures high-quality diagnostic information.

Conclusions:

  • Computerized Tomography TAVI (CT-TAVI) is a crucial imaging modality that significantly enhances procedural planning and guidance.
  • The selection of appropriate CT protocols and imaging devices is paramount for successful TAVI outcomes.
  • Continuous advancements in CT technology are increasing the importance and effectiveness of CT-guided TAVI.

Keywords:
Aortic rootAortic valve diameterAtherosclerotic plaque levels and degree of stenosisContrast injectionsCoronary vesselsDiameterPercutan aortic valve implantationSinus heightsSinus valsalvaTranscatheter aortic implantation procedure width

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