State-of-the-art aortic imaging: Part II - applications in transcatheter aortic valve replacement and endovascular aortic aneurysm repair

Fabian Rengier, Philipp Geisbüsch, Paul Schoenhagen, Matthias Müller-Eschner, Rolf Vosshenrich, Christof Karmonik, Hendrik von Tengg-Kobligk, Sasan Partovi

Research output: Contribution to journalArticlepeer-review

16 Scopus citations

Abstract

Transcatheter aortic valve replacement (TAVR) as well as thoracic and abdominal endovascular aortic repair (TEVAR and EVAR) rely on accurate pre- and postprocedural imaging. This review article discusses the application of imaging, including preprocedural assessment and measurements as well as postprocedural imaging of complications. Furthermore, the exciting perspective of computational fluid dynamics (CFD) based on cross-sectional imaging is presented. TAVR is a minimally invasive alternative for treatment of aortic valve stenosis in patients with high age and multiple comorbidities who cannot undergo traditional open surgical repair. Given the lack of direct visualization during the procedure, pre- and peri-procedural imaging forms an essential part of the intervention. Computed tomography angiography (CTA) is the imaging modality of choice for preprocedural planning. Routine postprocedural follow-up is performed by echocardiography to confirm treatment success and detect complications. EVAR and TEVAR are minimally invasive alternatives to open surgical repair of aortic pathologies. CTA constitutes the preferred imaging modality for both preoperative planning and postoperative follow-up including detection of endoleaks. Magnetic resonance imaging is an excellent alternative to CT for postoperative follow-up, and is especially beneficial for younger patients given the lack of radiation. Ultrasound is applied in screening and postoperative follow-up of abdominal aortic aneurysms, but cross-sectional imaging is required once abnormalities are detected. Contrast-enhanced ultrasound may be as sensitive as CTA in detecting endoleaks.

Original languageEnglish (US)
Pages (from-to)6-26
Number of pages21
JournalVasa - Journal of Vascular Diseases
Volume43
Issue number1
DOIs
StatePublished - Jan 2014

Keywords

  • Aortic Aneurysm, Abdominal
  • Aortic Aneurysm, Thoracic
  • Aortic Valve
  • Aortography
  • Cardiac Catheterization
  • Computer Simulation
  • Echocardiography
  • Endovascular Procedures
  • Heart Valve Diseases
  • Heart Valve Prosthesis Implantation
  • Humans
  • Magnetic Resonance Angiography
  • Models, Cardiovascular
  • Multimodal Imaging
  • Predictive Value of Tests
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Ultrasonography, Doppler

Fingerprint Dive into the research topics of 'State-of-the-art aortic imaging: Part II - applications in transcatheter aortic valve replacement and endovascular aortic aneurysm repair'. Together they form a unique fingerprint.

Cite this