Practical update on imaging and transcatheter aortic valve implantation

Abstract

After very rapid advances in the development of the technique and devices, transcatheter aortic valve implantation (named TAVI or TAVR), is today a reality that is here to stay. It has become the minimally-invasive treatment option for high-risk and non-surgical patients with severe symptomatic aortic stenosis. Requiring the participation of a multidisciplinary team for its implementation, cardiac imaging plays an important role. From pre-assessment to determine the suitability of the patient, the access site, the type of device, to the guidance during the procedure, and ultimately the long term monitoring of the patient. Correct selection of the patient and device, correct placement of the stent-valve and early detection of complications are of paramount importance for procedural success and for patient outcome. Each technique has advantages and disadvantages, being the cardiologist who will determine the best approach according to the type of patient and the expertise of the center in each one of them. This article summarizes the last contributions of the most common used imaging techniques, in each step of the procedure.

Keywords: TAVI, TAVR, Echocardiography, Multislice tomography, Cardiac magnetic resonance, Aortic stenosis

Core tip: Cardiac imaging is of crucial importance in the whole process of transcatheter aortic valve implantation, from initial evaluation, intraprocedural guidance and post implantation evaluation and early detection of complications. Multiple techniques are available for this, and as the rapid development of new devices and equipments, the greater the necessity of being aware of these advances. We provide current data and tips for this purpose. This is the reason of this work.