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The use of MSCT for the evaluation of the aortic root before transcutaneous aortic valve implantation: the Rotterdam approach

2010; European Association of Percutaneous Cardiovascular Interventions; Volume: 6; Issue: 4 Linguagem: Inglês

10.4244/eij30v6i4a84

1969-6213

Carl Schultz, Adriaan Moelker, Apostolos Tzikas, Nicolò Piazza, Pim de Feyter, Robert J. Van Geuns, Patrick W. Serruys, Gabriël P. Krestin, Peter de Jaegere,

Aortic Disease and Treatment Approaches

Whereas transthoracic echocardiography is the modality of choice for the diagnosis of severe aortic stenosis and cine-fluoroscopy is used to guide the implantation of the TAVI prosthesis, we believe that multislice computer tomography (MSCT) is the modality of choice for evaluation of the aortic root with a view to selecting patients with suitable anatomy and to guide sizing. We aim to describe an anatomical approach for the step by step interrogation of a 3D MSCT dataset to obtain the measurements of the aortic root required for patient selection, sizing and selection of the optimal angulation of the C-arm during the implantation procedure.The landmarks used to anatomically define the aortic annulus and structures of the aortic root may be used to define the same structures for measurement on a 3D MSCT dataset by setting up orthogonal cut-planes including one axial to the aortic annulus. This allows true axial diameter measurements and also enables us to define the valve plane.Measurement on the axial images avoids incorrect diameter measurements that do not pass through the central axis.