CT in Transcatheter-delivered Treatment of Valvular Heart Disease
Piotr Nikodem Rudziński, Jonathon Leipsic, U. Joseph Schoepf, Dariusz Dudek, Florian Schwarz, Martin Andreas, Adriana Złahoda-Huzior, Christian Thilo, Matthias Renker, Jeremy R. Burt, Tilman Emrich, Ákos Varga‐Szemes, Nicholas Amoroso, Daniel Steinberg, Piotr Pukacki, Marcin Demkow, Cezary Kępka, Richard R. Bayer
Abstract
Minimally invasive strategies to treat valvular heart disease have emerged over the past 2 decades. The use of transcatheter aortic valve replacement in the treatment of severe aortic stenosis, for example, has recently expanded from high- to low-risk patients and became an alternative treatment for those with prohibitive surgical risk. With the increase in transcatheter strategies, multimodality imaging, including echocardiography, CT, fluoroscopy, and cardiac MRI, are used. Strategies for preprocedural imaging strategies vary depending on the targeted valve. Herein, an overview of preprocedural imaging strategies and their postprocessing approaches is provided, with a focus on CT. Transcatheter aortic valve replacement is reviewed, as well as less established minimally invasive treatments of the mitral and tricuspid valves. In addition, device-specific details and the goals of CT imaging are discussed. Future imaging developments, such as peri-procedural fusion imaging, machine learning for image processing, and mixed reality applications, are presented.