title: Transcatheter aortic valve replacement: postoperative CT findings of Sapien and CoreValve transcatheter heart valves.
abstract: Transcatheter aortic valve replacement represents one of the most exciting medical technical developments in recent years, offering a much-needed therapeutic alternative for patients with severe aortic valve stenosis who, due to comorbidities and advanced age, are considered to be inoperable or at high surgical risk. The efficacy of this procedure compared with standard surgical intervention has been properly validated in multicenter randomized controlled trials (PARTNER A and B trials), leading to widespread clinical implementation, with over 50,000 procedures currently being performed worldwide each year. Although much of the attention has rightly focused on the potential role of computed tomography (CT) in the preprocedural assessment of the aortic root and the establishment of imaging-guided valve-sizing algorithms, less is known regarding the postprocedural CT characteristics of transcatheter heart valves (THVs). However, given the increasing worldwide recognition and clinical implementation of these devices, they will no doubt be encountered with increasing frequency in patients referred for thoracic CT, either for postprocedural evaluation of the aortic root or for unrelated reasons. Familiarity with these devices and their CT characteristics will increase diagnostic confidence and the value of the radiology report. The authors describe the physical and imaging properties of the currently commercially available THVs, their normal postprocedural imaging appearances, and potential complications that can be detected at CT. In addition, they discuss the relative strengths and weaknesses of CT and echocardiography in this setting.
authors.affiliation: From the Departments of Radiology (R.A.S., B.J.O.d.B., P.M.P.), Cardiology (B.S., P.L.V.H., C.V., J.B.), and Cardiothoracic Surgery (I.R.), Antwerp University Hospital, Wilrijkstraat 10, 2650 Edegem-Antwerp, Belgium; and Departments of Radiology (R.P.J.B., T.L.), Cardiothoracic Surgery (M.P.B.), and Cardiology (P.R.S.), University Medical Center Utrecht, Utrecht, the Netherlands.
authors.forename: Rodrigo A
authors.initials: RA
authors.lastname: Salgado
authors.forename: Ricardo P J
authors.initials: RP
authors.lastname: Budde
authors.forename: Tim
authors.initials: T
authors.lastname: Leiner
authors.forename: Bharati
authors.initials: B
authors.lastname: Shivalkar
authors.forename: Paul L
authors.initials: PL
authors.lastname: Van Herck
authors.forename: Bart J
authors.initials: BJ
authors.lastname: Op de Beeck
authors.forename: Christiaan
authors.initials: C
authors.lastname: Vrints
authors.forename: Marc P
authors.initials: MP
authors.lastname: Buijsrogge
authors.forename: Pieter R
authors.initials: PR
authors.lastname: Stella
authors.forename: Inez
authors.initials: I
authors.lastname: Rodrigus
authors.forename: Johan
authors.initials: J
authors.lastname: Bosmans
authors.forename: Paul M
authors.initials: PM
authors.lastname: Parizel
mesh_terms: D001024:Aortic Valve Stenosis / Q000601:surgery*; D006350:Heart Valve Prosthesis; D006801:Humans; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D011474:Prosthesis Design; D014057:Tomography, X-Ray Computed / Q000379:methods*; D065467:Transcatheter Aortic Valve Replacement