Role of Cardiac Computed Tomography in Planning Transcatheter Mitral Valve Replacement (TMVR)

Curr Cardiol Rep. 2022 Dec;24(12):1917-1932. doi: 10.1007/s11886-022-01794-2. Epub 2022 Nov 5.

Abstract

Purpose of review: Transcatheter mitral valve replacement (TMVR) is an evolving and rapidly expanding field within structural interventions, offering renewed treatment options for patients with high-risk mitral valve disease. We aim to highlight and illustrate the importance of cardiac CT in the planning of TMVR.

Recent findings: As TMVR has evolved, so has the specific nuances of cardiac CT planning, we now understand the importance of accurate annular sizing and valve simulation to predict complications such as neo-LVOT obstruction and paravalvular leak (PVL). More so than any other modality, cardiac CT remains instrumental in accurately planning TVMR from feasibility, device sizing, access, and fluoroscopic angles. Cardiac CT remains the key modality in TMVR evaluation, often the first step in determining patient eligibility through comprehensive procedural planning as well as informing potential outcomes and prognosis. In this review, we discuss the critical role of cardiac computed tomography (CT) and the specific considerations involved in TMVR.

Keywords: Cardiac CT; Mitral valve; Preprocedural planning; Transcatheter interventions.

Publication types

  • Review

MeSH terms

  • Cardiac Catheterization / methods
  • Heart Valve Prosthesis Implantation* / methods
  • Heart Valve Prosthesis* / adverse effects
  • Humans
  • Mitral Valve / diagnostic imaging
  • Mitral Valve / surgery
  • Mitral Valve Insufficiency* / complications
  • Mitral Valve Insufficiency* / diagnostic imaging
  • Mitral Valve Insufficiency* / surgery
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Ventricular Outflow Obstruction* / surgery