title: ACR appropriateness criteria imaging for transcatheter aortic valve replacement.
abstract: Although aortic valve replacement is the definitive therapy for severe aortic stenosis, almost half of patients with severe aortic stenosis are unable to undergo conventional aortic valve replacement because of advanced age, comorbidities, or prohibitive surgical risk. Treatment options have been recently expanded with the introduction of catheter-based implantation of a bioprosthetic aortic valve, referred to as transcatheter aortic valve replacement. Because this procedure is characterized by lack of exposure of the operative field, image guidance plays a critical role in preprocedural planning. This guideline document evaluates several preintervention imaging examinations that focus on both imaging at the aortic valve plane and planning in the supravalvular aorta and iliofemoral system. The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every 2 years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances in which evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment.
authors.affiliation: University of Chicago, Chicago, Illinois.
authors.forename: Karin E
authors.initials: KE
authors.lastname: Dill
authors.forename: Elizabeth
authors.initials: E
authors.lastname: George
authors.forename: Suhny
authors.initials: S
authors.lastname: Abbara
authors.forename: Kristopher
authors.initials: K
authors.lastname: Cummings
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Francois
authors.forename: Marie D
authors.initials: MD
authors.lastname: Gerhard-Herman
authors.forename: Heather L
authors.initials: HL
authors.lastname: Gornik
authors.forename: Michael
authors.initials: M
authors.lastname: Hanley
authors.forename: Sanjeeva P
authors.initials: SP
authors.lastname: Kalva
authors.forename: Jacobo
authors.initials: J
authors.lastname: Kirsch
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Kramer
authors.forename: Bill S
authors.initials: BS
authors.lastname: Majdalany
authors.forename: John M
authors.initials: JM
authors.lastname: Moriarty
authors.forename: Isabel B
authors.initials: IB
authors.lastname: Oliva
authors.forename: Matthew P
authors.initials: MP
authors.lastname: Schenker
authors.forename: Richard
authors.initials: R
authors.lastname: Strax
authors.forename: Frank J
authors.initials: FJ
authors.lastname: Rybicki
mesh_terms: D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging* / Q000601:surgery*; D006328:Cardiac Catheterization / Q000592:standards*; D019317:Evidence-Based Medicine; D019918:Heart Valve Prosthesis Implantation / Q000592:standards*; D006801:Humans; D017410:Practice Guidelines as Topic; D015641:Radiography, Interventional / Q000592:standards*; D014481:United States
keywords: Appropriateness criteria; aortic valve stenosis; computed tomographic angiography; echocardiography; magnetic resonance angiography; transcatheter aortic valve replacement