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Open Access 01-07-2015 | Vascular-Interventional

MDCT evaluation of aortic root and aortic valve prior to TAVI. What is the optimal imaging time point in the cardiac cycle?

Authors: Tomas Jurencak, Jakub Turek, Bastiaan L. J. H. Kietselaer, Casper Mihl, Madeleine Kok, Vincent G. V. A. van Ommen, Leen A. F. M. van Garsse, Estelle C. Nijssen, Joachim E. Wildberger, Marco Das

Published in: European Radiology | Issue 7/2015

Abstract

Objectives

To determine the optimal imaging time point for transcatheter aortic valve implantation (TAVI) therapy planning by comprehensive evaluation of the aortic root.

Methods

Multidetector-row CT (MDCT) examination with retrospective ECG gating was retrospectively performed in 64 consecutive patients referred for pre-TAVI assessment. Eighteen different parameters of the aortic root were evaluated at 11 different time points in the cardiac cycle. Time points at which maximal (or minimal) sizes were determined, and dimension differences to other time points were evaluated. Theoretical prosthesis sizing based on different measurements was compared.

Results

Largest dimensions were found between 10 and 20 % of the cardiac cycle for annular short diameter (10 %); mean diameter (10 %); effective diameter and circumference-derived diameter (20 %); distance from the annulus to right coronary artery ostium (10 %); aortic root at the left coronary artery level (20 %); aortic root at the widest portion of coronary sinuses (20 %); and right leaflet length (20 %). Prosthesis size selection differed depending on the chosen measurements in 25–75 % of cases.

Conclusion

Significant changes in anatomical structures of the aortic root during the cardiac cycle are crucial for TAVI planning. Imaging in systole is mandatory to obtain maximal dimensions.

Key Points

• Most aortic root structures undergo significant dimensional changes throughout the cardiac cycle.

• The largest dimensions of aortic parameters should be determined to optimize TAVI.

• Circumference-derived diameter showed maximum dimension at 20 % of the cardiac cycle.

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Title: MDCT evaluation of aortic root and aortic valve prior to TAVI. What is the optimal imaging time point in the cardiac cycle?
Authors: Tomas Jurencak
Jakub Turek
Bastiaan L. J. H. Kietselaer
Casper Mihl
Madeleine Kok
Vincent G. V. A. van Ommen
Leen A. F. M. van Garsse
Estelle C. Nijssen
Joachim E. Wildberger
Marco Das
Publication date: 01-07-2015
Publisher: Springer Berlin Heidelberg
Published in: European Radiology / Issue 7/2015
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-015-3607-5

At a glance: The STEP trials

Springer Medicine

MDCT evaluation of aortic root and aortic valve prior to TAVI. What is the optimal imaging time point in the cardiac cycle?

Abstract

Objectives

Methods

Results

Conclusion

Key Points

At a glance: The STEP trials

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusion

Key Points

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