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Transcatheter Aortic Valve Replacement

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2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines Transcatheter aortic-valve replacement with a self-expanding prosthesis Transcatheter Aortic Valve Replacement in Patients With Multivalvular Heart Disease Predictors and Clinical Outcomes of Next-Day Discharge After Minimalist Transfemoral Transcatheter Aortic Valve Replacement Conscious Sedation Versus General Anesthesia for Transcatheter Aortic Valve Replacement: Variation in Practice and Outcomes Long-Term Durability of Transcatheter Heart Valves: Insights From Bench Testing to 25 Years Contemporary real-world outcomes of surgical aortic valve replacement in 141,905 low-risk, intermediate-risk, and high-risk patients Early Surgery or Conservative Care for Asymptomatic Aortic Stenosis Transcatheter Aortic Valve Replacement: Role of Multimodality Imaging in Common and Complex Clinical Scenarios Transcatheter versus Surgical Aortic Valve Replacement in Patients with Prior Cardiac Surgery in the Randomized PARTNER 2A Trial
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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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