Multidetector Computed Tomography in Transcatheter Aortic Valve Implantation》.pdfVIP

J A C C : C A R D I O V A S C U L A R I M A G I N G V O L . 4 , N O . 4 , 2 0 1 1 © 2 0 1 1 B Y T H E A M E R I C A N C O L L E G E O F C A R D I O L O G Y F O U N D A T I O N I S S N 1 9 3 6 - 8 7 8 X / $ 3 6 . 0 0 P U B L I S H E D B Y E L S E V I E R I N C . D O I : 1 0 . 1 0 1 6 / j . j c m g . 2 0 1 1 . 0 1 . 0 1 4 F R O M P I C T U R E S T O P R A C T I C E P A R A D I G M S Multidetector Computed Tomography in Transcatheter Aortic Valve Implantation Jonathon Leipsic, MD,* Ronen Gurvitch, MD,‡ Troy M. LaBounty, MD,§ James K. Min, MD,§ David Wood, MD,‡ Mark Johnson, MD,† Amr M. Ajlan, MD,† Namal Wijesinghe, MD,‡ John G. Webb, MD‡ Vancouver, British Columbia, Canada; and New York, New York Aortic stenosis is a common disorder. Aortic valve replacement is indicated in symptomatic patients with severe aortic stenosis, as the prognosis of untreated patients is poor. Nevertheless, many patients pose a prohibitively high surgical risk and are not candidates for surgical valve replacement. Transcatheter aortic valve implantation (TAVI) is a novel method to treat selected high-risk patients with aortic stenosis. Patient screening and anatomic measurements of the aortic root are of great importance to ensure procedural success and appropriate patient selection. Multidetector computed tomography (CT) is playing an increasingly impor- tant role in patient screening protocols before TAVI, provides detailed anatomic assessment of the aortic root and valve annulus, assesses the suitability of iliofemoral access, and determines appropriate coaxial angles to optimize the valve implantation procedure. Additionally, CT is providing a greater understanding of medium- term valve durability and integrity. This review outlines an evolving role for CT angiography in support of