The Role of Cardiac Computed Tomography in Valve Disease and Valve Intervention Planning
- PDF / 9,583,099 Bytes
- 21 Pages / 595.276 x 790.866 pts Page_size
- 77 Downloads / 171 Views
(2021) 23:3
Valvular Heart Disease (J Dal-Bianco, Section Editor)
The Role of Cardiac Computed Tomography in Valve Disease and Valve Intervention Planning Angelo K. Takigami, MD Brian Ghoshhajra, MD, MBA, FSCCT Sandeep Hedgire, MD* Address * Cardiovascular Imaging, Department of Radiology, and Division of Cardiology Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, Boston, MA, 02114, USA Email: [email protected]
* Springer Science+Business Media, LLC, part of Springer Nature 2020
This article is part of the Topical Collection on Valvular Heart Disease Keywords Cardiac computed tomography I Valve disease I Transcatheter valve replacement I TAVR I TMVR I TPVI I TTVI
Abstract Purpose of review This review aims to provide an overview of cardiac CT role in detection of valvular lesions and in transcatheter valve replacement. Recent findings Modern CT scans and protocols allow valve evaluation with high spatial and temporal resolution with reduced radiation dose. Cardiac CT is now mainstay of transcatheter aortic valve replacement (TAVR) planning. It plays a role in sizing of transcatheter aortic valve prosthesis, risk assessment for potential complications, prediction of ideal fluoroscopic angles, and selection of vascular access. Cardiac CT’s role in transcatheter mitral, pulmonic, and tricuspid valve replacements has evolved in conjunction with these new procedures. Summary We summarize the role of cardiac CT in the context of valvular diseases and transcatheter valve replacement planning.
Introduction Over the past decade, cardiac computed tomography (CT) has evolved into an important imaging modality
in valve evaluation. Advanced generations of cardiac CT scanners now allow rapid acquisition of high-quality
3
Page 2 of 21
Curr Treat Options Cardio Med
images with reduced motion artifacts and radiation. Reconstruction tools and multiphase acquisitions allow assessment of cardiac structure and function with high spatial and temporal resolution and enable adept detection of a variety of valvular lesions. While cardiac CT has established itself as an important non-invasive imaging tool in sizing of transcatheter aortic valve for replacement, risk assessment of complications, prediction of
(2021) 23:3
fluoroscopic projections, and assessing vascular access, its role in pre-procedure transcatheter replacement of tricuspid, pulmonic, and mitral valves is evolving [1]. This review aims to provide an overview of cardiac CT in detection of valvular lesions and its role in providing a road map prior to the planned transcatheter valve replacement.
CT technique for valvular evaluation: technical aspects and contrast injection Optimal contrast enhancement is key in cardiac CT angiography. Contrast should be injected at a specific rate and duration to allow the enhancement of the structures and minimizing streak artifacts. The injection rate of 5 mL/s is frequently used and it should last at least the same duration of the acquisition [2]. Dual-head power injectors allow multiphasic i
Data Loading...
