Cardiac Computed Tomography in Structural Heart Interventions: From Preprocedural Planning to Procedural Strategy

Cardiac computed tomography (CT) has become an essential imaging modality in structural cardiac interventions, providing high-resolution anatomical and functional assessments. Moreover, the role of cardiac CT spans pre-procedural planning, intra-procedural guidance, and post-procedural follow-up in interventions such as transcatheter aortic valve implantation (TAVI), mitral, tricuspid, and pulmonary valve interventions, left atrial appendage occlusion (LAAO), atrial septal defect (ASD), and paravalvular leak (PVL) closures. Furthermore, compared to traditional imaging techniques, cardiac CT offers superior spatial resolution, precise anatomical characterization, and improved procedural success rates by minimizing complications. Additionally, advances in artificial intelligence (AI)-driven CT analysis, perfusion imaging, and four-dimensional cardiac CT are expanding the associated applications. This review discusses the current role, benefits, limitations, and future perspectives of cardiac CT in guiding structural heart interventions.