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

Carl Schultz, Adriaan Moelker, Apostolos Tzikas, Nicolo Piazza, Pim De Feyter, Robert J. Van Geuns, Patrick W. Serruys, Gabriel P. Krestin, Peter De Jaegere

Research output: Contribution to journalArticle

33 Citations (Scopus)

Abstract

Aims: 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. Methods and results: 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. Conclusions: Measurement on the axial images avoids incorrect diameter measurements that do not pass through the central axis.

Original languageEnglish
Pages (from-to)505-511
Number of pages7
JournalEuroIntervention
Volume6
Issue number4
DOIs
Publication statusPublished - 1 Jan 2010
Externally publishedYes

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