Computed Tomography Imaging Prior to Transcatheter Aortic Valve Replacement

Abstract

Transcatheter aortic valve replacement (TAVR) has emerged as an effective and lower risk treatment option for patients with severe aortic stenosis deemed to be too high risk for surgical replacement. Careful pre-procedural evaluation of aortic annular geometry is pertinent for appropriate transcatheter aortic valve sizing in such patients with three-dimensional datasets provided by multi-detector computed tomography (MDCT) proven to be superior in aortic annular evaluation. Moreover, MDCT plays an important role in the assessment of annular calcification associated with aortic root complications, as well as, the identification of patients at increased risk of coronary occlusion and the determination of co-planar angulations used for valve deployment during the TAVR procedure. In this review, we discuss the rationale for aortic annular assessment prior to TAVR using MDCT with a particular focus on transcatheter aortic valve sizing.