The role of advanced imaging in transcatheter aortic valve implantation
Year: 2011
Type: dissertation
Abstract: Aortic stenosis, currently the most prevalent valvular heart disease in Europe, is an important public health problem, affecting thousands of patients every year. While surgical\\naortic valve replacement is still considered the \\xe2\\x80\\x9cgold standard\\xe2\\x80\\x9d treatment, recent innovations in transcatheter valve therapies have offered an attractive alternative: transcatheter\\naortic valve implantation (TAVI). In 2002, Cribier et al. announced the first human case description of a percutaneously implanted heart valve in a patient suffering from severe aortic\\nstenosis. Since then, the number of patients that undergo TAVI has increased exponentially.\\nPreliminary early and midterm results following TAVI have been promising. However, despite satisfactory hemodynamic results, TAVI procedures still face important\\nsafety issues such as paravalvular leaks, vascular complications, stroke, conduction disorders\\nand the need for pacemaker implantation. Currently, TAVI is offered only to patients who are considered high risk candidates for surgical aortic valve replacement.\\nA fundamental characteristic of percutaneous interventions is the lack of direct visualization\\nof the target organ/tissue. Consequently, interventional cardiology is greatly related\\nto and depending on imaging. Especially in TAVI, which is entering the field of traditional\\nvalve surgery, the role of multimodality cardiac imaging is mandatory. Contrast aortography, multi slice computed tomography (MSCT), magnetic resonance imaging and echocardiography can provide a detailed characterisation of vascular anatomy, aortic root dimensions, aortic valve calcifications and left ventricular (LV) function. The use of these imaging techniques is invaluable for patient selection and planning of the procedure. In addition, some techniques can be used during the operation to guide the implantation, as well as after the procedure to evaluate the positioning and function of the prosthesis.\\nTAVI is a fascinating technology but it is still in its infancy. Further studies are needed\\nin order to understand and modulate TAVI. The aim of the present thesis is to investigate\\nthe role of advanced cardiac imaging for TAVI.
Author: Apostolos Tzikas
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W1930776159