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Transcatheter Aortic Valve Replacement

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Outcomes 2 Years After Transcatheter Aortic Valve Replacement in Patients at Low Surgical Risk Surgical or Transcatheter Aortic-Valve Replacement in Intermediate-Risk Patients Procedural and clinical outcomes of type 0 versus type 1 bicuspid aortic valve stenosis undergoing trans-catheter valve replacement with new generation devices: Insight from the BEAT international collaborative registry Transcatheter Aortic-Valve Replacement with a Balloon-Expandable Valve in Low-Risk Patients Suture- or Plug-Based Large-Bore Arteriotomy Closure: A Pilot Randomized Controlled Trial Prior Balloon Valvuloplasty Versus Direct Transcatheter Aortic Valve Replacement: Results From the DIRECTAVI Trial Evaluation and Management of Aortic Stenosis in Chronic Kidney Disease: A Scientific Statement From the American Heart Association Aspirin with or without Clopidogrel after Transcatheter Aortic-Valve Implantation Clinical Impact of Valvular Heart Disease in Elderly Patients Admitted for Acute Coronary Syndrome: Insights From the Elderly-ACS 2 Study Evolving concepts in the management of antithrombotic therapy in patients undergoing transcatheter aortic valve implantation
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Review ArticleVolume 12, Issue 9, September 2019

JOURNAL：J Am Coll Cardiol. ACC Cardiovasc Imaging. Article Link

Why and How to Measure Aortic Valve Calcification in Patients With Aortic Stenosis

T Pawade, T Sheth, E Guzzetti, MR Dweck et al. Keywords: aortic stenosis；aortic valve calcification； computed tomography

ABSTRACT

The first-line evaluation of aortic stenosis severity is Doppler echocardiography. However, in up to 40% of patients, resting echocardiographic assessment of aortic stenosis severity is discordant, leading to clinical uncertainty. Interest has therefore grown in aortic valve calcium scoring by multidetector computed tomography (CT-AVC) as an alternative load independent assessment of aortic stenosis severity. This paper will briefly review the pathophysiology of aortic stenosis and the crucial role that calcification plays in driving progressive obstruction of the valve. Subsequently, it will describe published reports that have investigated CT-AVC, validating this parameter against histology, and establishing its diagnostic accuracy versus echocardiography as well as its powerful independent prognostic capability. Finally, this review seeks to provide a practical guide about how best to acquire and interpret CT-AVC with a close focus on potential pitfalls and how these might be best avoided as this technique becomes more widely adopted in to clinical practice.
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