Cardiac computed tomography post-transcatheter aortic valve replacement

被引:0
作者
He, Albert [1 ,2 ]
Wilkins, Ben [2 ]
Lan, Nick S. R. [1 ,3 ,4 ]
Othman, Farrah [1 ]
Sehly, Amro [1 ]
Bhat, Vikas [1 ]
Jaltotage, Biyanka [1 ]
Dwivedi, Girish [1 ,3 ,4 ]
Leipsic, Jonathon [5 ]
Ihdayhid, Abdul Rahman [1 ,3 ,6 ]
机构
[1] Fiona Stanley Hosp, Dept Cardiol, 11 Robin Warren Dr, Perth, WA, Australia
[2] Dunedin Publ Hosp, Dept Cardiol, Dunedin, New Zealand
[3] Harry Perkins Inst Med Res, Perth, Australia
[4] Univ Western Australia, Med Sch, Perth, Australia
[5] Univ British Columbia, St Pauls Hosp, Dept Radiol, Vancouver, BC, Canada
[6] Curtin Univ, Med Sch, Perth, Australia
基金
英国医学研究理事会;
关键词
Transcatheter aortic valve replacement; Transcatheter heart valve; TAVI; TAVR; CT angiography; Cardiac imaging; Aortic valve; Aortic valve stenosis; PROSTHESIS-PATIENT MISMATCH; SUBCLINICAL LEAFLET THROMBOSIS; CORONARY ACCESS; AMERICAN SOCIETY; RISK; OUTCOMES; TAVR; IMPLANTATION; OBSTRUCTION; STENOSIS;
D O I
10.1016/j.jcct.2024.04.014
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Transcatheter aortic valve replacement (TAVR) is performed to treat aortic stenosis and is increasingly being utilised in the low-to-intermediate-risk population. Currently, attention has shifted towards long-term outcomes, complications and lifelong maintenance of the bioprosthesis. Some patients with TAVR in-situ may develop significant coronary artery disease over time requiring invasive coronary angiography, which may be problematic with the TAVR bioprosthesis in close proximity to the coronary ostia. In addition, younger patients may require a second transcatheter heart valve (THV) to 'replace' their in-situ THV because of gradual structural valve degeneration. Implantation of a second THV carries a risk of coronary obstruction, thereby requiring comprehensive pre-procedural planning. Unlike in the pre-TAVR period, cardiac CT angiography in the post-TAVR period is not well established. However, post-TAVR cardiac CT is being increasingly utilised to evaluate mechanisms for structural valve degeneration and complications, including leaflet thrombosis. Post-TAVR CT is also expected to have a significant role in risk-stratifying and planning future invasive procedures including coronary angiography and valve-invalve interventions. Overall, there is emerging evidence for post-TAVR CT to be eventually incorporated into long-term TAVR monitoring and lifelong planning.
引用
收藏
页码:319 / 326
页数:8
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