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Review
. 2022 May 5;11(9):2582.
doi: 10.3390/jcm11092582.

Preoperative TAVR Planning: How to Do It

Rodrigo Petersen Saadi  1 , Ana Paula Tagliari  1   2 , Eduardo Keller Saadi  1   2   3 , Marcelo Haertel Miglioranza  4 , Carisi Anne Polanczyck  1   5
Affiliations
Review

Preoperative TAVR Planning: How to Do It

Rodrigo Petersen Saadi et al. J Clin Med. .

Abstract

Transcatheter aortic valve replacement (TAVR) is a well-established treatment option for patients with severe symptomatic aortic stenosis (AS) whose procedural efficacy and safety have been continuously improving. Appropriate preprocedural planning, including aortic valve annulus measurements, transcatheter heart valve choice, and possible procedural complication anticipation is mandatory to a successful procedure. The gold standard for preoperative planning is still to perform a multi-detector computed angiotomography (MDCT), which provides all the information required. Nonetheless, 3D echocardiography and magnet resonance imaging (MRI) are great alternatives for some patients. In this article, we provide an updated comprehensive review, focusing on preoperative TAVR planning and the standard steps required to do it properly.

Keywords: 3D echocardiography; MDCT; MRI; TAVR; planning; sizing.

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Conflict of interest statement

Tagliari A.P. had received a research grant from the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior—Brasil (CAPES)—Finance Code 001. Saadi E.K. is a proctor in TAVI for Medtronic, Edwards and Abbott.

Figures

Figure 1
Figure 1
Aortic valve measurement using contrast injection from a pigtail catheter.
Figure 2
Figure 2
Virtual aortic annulus, sinotubular junction, and coronary arteries anatomy (adapted from Zarayelyan A. et al. [20]).
Figure 3
Figure 3
A MPR reconstruction from MDCT images using the Horos® software.
Figure 4
Figure 4
Measurements performed using the 3MensioValves.
Figure 5
Figure 5
ProSizeAV report.
Figure 6
Figure 6
Example of a 3D transesophageal echocardiography aortic root assessment.
Figure 7
Figure 7
Example of a non-contrast 3D ‘whole heart’ MRI (a) aortic annular, arrows showing the minimum and maximum diameters, (b) right coronary and (c) left coronary arteries height (orange arrows), (d) maximum intensity projection of aortoiliofemoral MRI and (e) MDCT image (adapted from Pammiger et al. [52]).
See this image and copyright information in PMC

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