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Improved Registration of 3D CT Angiography with X-ray Fluoroscopy for Image Fusion During Transcatheter Aortic Valve Implantation
Published on: June 3, 2018
Intravascular Ultrasound for the Prevention of Coronary Artery Occlusion During Transcatheter Aortic Valve
Helena Krysztofiak1, Krzysztof Krawczyk1, Witold Gwóźdź2
1Department of Cardiology, University Hospital, Institute of Medical Sciences, University of Opole, Opole, Poland.
Insights
Computed tomography angiography (CTA) has limitations in predicting coronary artery occlusion post-transcatheter aortic valve replacement (TAVR). Intravascular ultrasound (IVUS) offers improved clarity for managing potential coronary complications.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Medical Imaging
Background:
- Predicting coronary artery occlusion after transcatheter aortic valve replacement (TAVR) is crucial for patient safety.
- Computed tomography angiography (CTA) is the standard imaging modality but can provide ambiguous risk assessments.
- Low coronary artery take-off and small aortic root are identified risk factors, yet uncertainty persists regarding intervention.
Abstract:
Predicting coronary artery occlusion after transcatheter aortic valve replacement (TAVR) is usually based on computed tomography angiography (CTA). The primary risk factors seem to be a low coronary artery take-off and a small aortic root. However, CTA sometimes provides ambiguous risk assessment, and even if a potentially risky coronary artery is secured with a guidewire, the need for coronary stenting after valve implantation often remains uncertain. To reduce uncertainty, intravascular ultrasound (IVUS) can be used. The following two cases highlight the utility of IVUS in addressing these issues.
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