Optimizing Cardiac CT Protocols for Comprehensive Acquisition Prior to Percutaneous MV and TV Repair/Replacement
Autor: | Tamim Nazif, Vinayak Bapat, Torsten Vahl, Martin B. Leon, Omar K. Khalique, Jay Leb, Belinda D’Souza, Susheel Kodali, Andrew J. Einstein, Todd Pulerwitz, Isaac George, Shifali Dumeer, Rebecca T. Hahn |
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Rok vydání: | 2018 |
Předmět: |
medicine.medical_specialty
Cardiac Catheterization Percutaneous Mitral Valve Annuloplasty 030204 cardiovascular system & hematology Severity of Illness Index 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Predictive Value of Tests Mitral valve medicine Humans Radiology Nuclear Medicine and imaging TRICUSPID VALVE REPAIR Computed tomography angiography Heart Valve Prosthesis Implantation medicine.diagnostic_test business.industry Mitral Valve Insufficiency Tricuspid Valve Insufficiency Clinical trial medicine.anatomical_structure Treatment Outcome Angiography Mitral Valve Radiology Tricuspid Valve Cardiology and Cardiovascular Medicine business Tomography X-Ray Computed |
Zdroj: | JACC. Cardiovascular imaging. 13(3) |
ISSN: | 1876-7591 |
Popis: | Clinical trials of transcatheter mitral valve and tricuspid valve repair and replacement devices have begun in earnest, with the ultimate goal of providing definitive, nonsurgical treatment for the millions of patients with severe, symptomatic regurgitation, many of whom are too high risk or inoperable for a surgical approach. Computed tomography (CT) angiography offers the potential for detailed anatomic assessment in this patient population, but its optimal implementation for patients with mitral and tricuspid disease requires patient-centered protocol specification reflecting the goal of the scan, an understanding of complex anatomy and pathophysiology, and particulars of CT scanner capabilities. In this paper, the need for new interventional approaches to mitral and tricuspid valve disease is discussed, followed by a detailed review of how to perform a high-quality CT angiography examination, taking into consideration scanner- and patient-specific variables when preparing a pre-mitral or tricuspid protocol. The many possible clinical challenges affecting the performance of cardiac and vascular CT angiography for pre-procedure mitral and tricuspid repair/replacement are reviewed and specific tips, trouble-shooting approaches, and recommendations are provided for how to conduct the best-quality study, be it at an experienced imaging center with the most advanced scanner or at a novice center using an earlier generation CT platform. |
Databáze: | OpenAIRE |
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