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Eur Radiol. 2019 Sep 5. doi: 10.1007/s00330-019-06357-8. [Epub ahead of print]

CT and MR imaging prior to transcatheter aortic valve implantation: standardisation of scanning protocols, measurements and reporting-a consensus document by the European Society of Cardiovascular Radiology (ESCR).

Author information

1
Department of Radiological, Oncological and Pathological Sciences, Sapienza University, Policlinico Umberto I, V.le Regina Elena 324, 00161, Rome, Italy. marco.francone@uniroma1.it.
2
Department of Radiology & Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands.
3
Department of Radiology, University of Basel Hospital, Basel, Switzerland.
4
Department of Radiology, Normandie University, UNIROUEN, INSERM U1096 - Rouen University Hospital, F 76000, Rouen, France.
5
Division of Cardiovascular and Interventional Radiology, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria.
6
Department of Radiological Sciences - Institute of Radiology, Catholic University of Rome, "A. Gemelli" University Hospital, Rome, Italy.
7
Centro Cardiologico Monzino, IRCCS, Milan, Italy.
8
Institute of Cardiometabolism and Nutrition (ICAN), Paris, France.
9
Department of Cardiovascular and Thoracic, Imaging and Interventional Radiology, Institute of Cardiology, APHP, Pitié-Salpêtrière University Hospital, Paris, France.
10
Laboratoire d'Imagerie Biomédicale, Sorbonne Universités, UPMC Univ Paris 06, INSERM 1146, CNRS 7371, Paris, France.
11
Department of Radiology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands.
12
Department of Diagnostic and Interventional Radiology, University of Tuebingen, Tübingen, Germany.
13
Diagnostic and Interventional Radiology, University of Leipzig-Heart Center, Leipzig, Germany.
14
Department of Radiology, Antwerp University Hospital, Antwerp, Belgium.
15
Department of Radiology, Holy Heart Hospital, Lier, Belgium.

Abstract

Transcatheter aortic valve replacement (TAVR) is a minimally invasive alternative to conventional aortic valve replacement in symptomatic patients with severe aortic stenosis and contraindications to surgery. The procedure has shown to improve patient's quality of life and prolong short- and mid-term survival in high-risk individuals, becoming a widely accepted therapeutic option which has been integrated into current clinical guidelines for the management of valvular heart disease. Nevertheless, not every patient at high-risk for surgery is a good candidate for TAVR. Besides clinical selection, which is usually established by the Heart Team, certain technical and anatomic criteria must be met as, unlike in surgical valve replacement, annular sizing is not performed under direct surgical evaluation but on the basis of non-invasive imaging findings. Present consensus document was outlined by a working group of researchers from the European Society of Cardiovascular Radiology (ESCR) and aims to provide guidance on the utilisation of CT and MR imaging prior to TAVR. Particular relevance is given to the technical requirements and standardisation of the scanning protocols which have to be tailored to the remarkable variability of the scanners currently utilised in clinical practice; recommendations regarding all required pre-procedural measurements and medical reporting standardisation have been also outlined, in order to ensure quality and consistency of reported data and terminology. Key Points • To provide a reference document for CT and MR acquisition techniques, taking into account the significant technological variation of available scanners. • To review all relevant measurements that are required and define a step-by-step guided approach for the measurements of different structures implicated in the procedure. • To propose a CT/MR reporting template to assist in consistent communication between various sites and specialists involved in the procedural planning.

KEYWORDS:

Aortic valve stenosis; Consensus; Magnetic resonance imaging; Multidetector computed tomography; Transcatheter aortic valve replacement

PMID:
31489471
DOI:
10.1007/s00330-019-06357-8

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