title: Patient selection for transcatheter aortic valve replacement: A combined clinical and multimodality imaging approach.
abstract: Transcatheter aortic valve replacement (TAVR) has been validated as a new therapy for patients affected by severe symptomatic aortic stenosis who are not eligible for surgical intervention because of major contraindication or high operative risk. Patient selection for TAVR should be based not only on accurate assessment of aortic stenosis morphology, but also on several clinical and functional data. Multi-Imaging modalities should be preferred for assessing the anatomy and the dimensions of the aortic valve and annulus before TAVR. Ultrasounds represent the first line tool in evaluation of this patients giving detailed anatomic description of aortic valve complex and allowing estimating with enough reliability the hemodynamic entity of valvular stenosis. Angiography should be used to assess coronary involvement and plan a revascularization strategy before the implant. Multislice computed tomography play a central role as it can give anatomical details in order to choice the best fitting prosthesis, evaluate the morphology of the access path and detect other relevant comorbidities. Cardiovascular magnetic resonance and positron emission tomography are emergent modality helpful in aortic stenosis evaluation. The aim of this review is to give an overview on TAVR clinical and technical aspects essential for adequate selection.
authors.affiliation: Rosangela Cocchia, Rodolfo Citro, Eduardo Bossone, Department of Cardiology and Cardiac Surgery, San Giovanni di Dio Hospital, 00733 Salern, Italy.
authors.forename: Rosangela
authors.initials: R
authors.lastname: Cocchia
authors.affiliation: Rosangela Cocchia, Rodolfo Citro, Eduardo Bossone, Department of Cardiology and Cardiac Surgery, San Giovanni di Dio Hospital, 00733 Salern, Italy.
authors.forename: Antonello
authors.initials: A
authors.lastname: D'Andrea
authors.affiliation: Rosangela Cocchia, Rodolfo Citro, Eduardo Bossone, Department of Cardiology and Cardiac Surgery, San Giovanni di Dio Hospital, 00733 Salern, Italy.
authors.forename: Marianna
authors.initials: M
authors.lastname: Conte
authors.affiliation: Rosangela Cocchia, Rodolfo Citro, Eduardo Bossone, Department of Cardiology and Cardiac Surgery, San Giovanni di Dio Hospital, 00733 Salern, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Cavallaro
authors.affiliation: Rosangela Cocchia, Rodolfo Citro, Eduardo Bossone, Department of Cardiology and Cardiac Surgery, San Giovanni di Dio Hospital, 00733 Salern, Italy.
authors.forename: Lucia
authors.initials: L
authors.lastname: Riegler
authors.affiliation: Rosangela Cocchia, Rodolfo Citro, Eduardo Bossone, Department of Cardiology and Cardiac Surgery, San Giovanni di Dio Hospital, 00733 Salern, Italy.
authors.forename: Rodolfo
authors.initials: R
authors.lastname: Citro
authors.affiliation: Rosangela Cocchia, Rodolfo Citro, Eduardo Bossone, Department of Cardiology and Cardiac Surgery, San Giovanni di Dio Hospital, 00733 Salern, Italy.
authors.forename: Cesare
authors.initials: C
authors.lastname: Sirignano
authors.affiliation: Rosangela Cocchia, Rodolfo Citro, Eduardo Bossone, Department of Cardiology and Cardiac Surgery, San Giovanni di Dio Hospital, 00733 Salern, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Imbriaco
authors.affiliation: Rosangela Cocchia, Rodolfo Citro, Eduardo Bossone, Department of Cardiology and Cardiac Surgery, San Giovanni di Dio Hospital, 00733 Salern, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Cappelli
authors.affiliation: Rosangela Cocchia, Rodolfo Citro, Eduardo Bossone, Department of Cardiology and Cardiac Surgery, San Giovanni di Dio Hospital, 00733 Salern, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Gregorio
authors.affiliation: Rosangela Cocchia, Rodolfo Citro, Eduardo Bossone, Department of Cardiology and Cardiac Surgery, San Giovanni di Dio Hospital, 00733 Salern, Italy.
authors.forename: Raffaele
authors.initials: R
authors.lastname: Calabrò
authors.affiliation: Rosangela Cocchia, Rodolfo Citro, Eduardo Bossone, Department of Cardiology and Cardiac Surgery, San Giovanni di Dio Hospital, 00733 Salern, Italy.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Bossone
keywords: Aortic stenosis; Cardiac computed tomography; Cardiac magnetic resonance; Doppler echocardiography; Three dimensional echocardiography; Transcatheter aortic valve replacement; Two-dimensional strain