Pre-TAVI imaging: an Italian survey by the CT PRotocol optimization (CT-PRO) group

Area of Science:

• Radiology
• Cardiovascular Imaging
• Medical Imaging

Background:

• Transcatheter aortic valve implantation (TAVI) requires precise pre-procedural imaging.
• Current imaging practices and adherence to guidelines are crucial for TAVI success.
• Understanding the state-of-the-art in pre-TAVI imaging is essential for quality improvement.

Purpose of the Study:

• To evaluate the current practices of pre-TAVI imaging within a large Italian radiological community.
• To assess adherence to established guidelines for pre-TAVI imaging acquisition and reporting.

Main Methods:

• An online survey was distributed to members of the Italian Society of Medical and Interventional Radiology (SIRM).
• The questionnaire focused on pre-TAVI imaging protocols, contrast agent use, reporting practices, and Heart Team involvement.
• Data was collected from December 2022 to January 2023.

Main Results:

• 557 radiologists participated, with most employed in public hospitals.
• 84% routinely perform pre-TAVI imaging, commonly using ECG-gated CT angiography.
• While most reports followed guidelines, only 7% of respondents regularly attended Heart Team meetings, despite 60% having a Heart Team present.

Conclusions:

• The survey highlights that while pre-TAVI imaging acquisition and reporting align with guidelines among Italian radiologists, there's a significant gap in participation within multidisciplinary Heart Teams.
• This suggests a need to enhance radiologist integration into the Heart Team for comprehensive pre-TAVI patient management.