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Related Concept Videos

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Cardiac computed tomography post-transcatheter aortic valve replacement.

Albert He1, Ben Wilkins2, Nick S R Lan3

  • 1Department of Cardiology, Fiona Stanley Hospital, Perth, Australia; Department of Cardiology, Dunedin Public Hospital, Dunedin, New Zealand.

Journal of Cardiovascular Computed Tomography
|May 23, 2024
PubMed
Summary

Transcatheter aortic valve replacement (TAVR) monitoring requires advanced imaging. Post-TAVR cardiac CT angiography aids in assessing complications and planning future procedures for lifelong patient care.

Keywords:
Aortic valveAortic valve stenosisCT angiographyCardiac imagingTAVITAVRTranscatheter aortic valve replacementTranscatheter heart valve

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Area of Science:

  • Cardiovascular Imaging
  • Interventional Cardiology
  • Bioprosthetic Heart Valves

Background:

  • Transcatheter aortic valve replacement (TAVR) is now common for aortic stenosis in low-to-intermediate-risk patients.
  • Long-term TAVR outcomes, bioprosthesis maintenance, and complications are critical considerations.
  • Proximity of TAVR to coronary ostia complicates subsequent coronary angiography.

Purpose of the Study:

  • To evaluate the role of cardiac CT angiography (CCTA) in the post-TAVR period.
  • To explore CCTA's utility in managing complications and planning future interventions.
  • To assess CCTA's potential for long-term TAVR monitoring and lifelong management.

Main Methods:

  • Review of current literature and emerging evidence on post-TAVR CCTA utilization.
  • Analysis of CCTA's application in evaluating structural valve degeneration and leaflet thrombosis.
  • Assessment of CCTA's role in pre-procedural planning for coronary angiography and valve-in-valve interventions.

Main Results:

  • Post-TAVR CCTA is increasingly used to investigate valve degeneration and complications like leaflet thrombosis.
  • CCTA is crucial for risk stratification and planning complex procedures such as repeat valve interventions.
  • The technique is vital for managing potential coronary obstruction during valve-in-valve procedures.

Conclusions:

  • Cardiac CT angiography is becoming essential for post-TAVR assessment and management.
  • Emerging evidence supports incorporating post-TAVR CCTA into long-term monitoring protocols.
  • CCTA plays a key role in lifelong planning for patients with TAVR.