Spotlight Issue: Aortic Valve & TAVR
Recommendations for Comprehensive Intraprocedural Echocardiographic Imaging During TAVR

https://doi.org/10.1016/j.jcmg.2014.12.014Get rights and content
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Abstract

Recent multicenter trials have shown that transcatheter aortic valve replacement is an alternative to surgery in a high risk population of patients with severe, symptomatic aortic stenosis. Echocardiography and multislice computed tomographic imaging are accepted tools in the pre-procedural imaging of the aortic valve complex and vascular access. Transesophageal echocardiography can be valuable for intraprocedural confirmation of the landing zone morphology and measurements, positioning of the valve and post-procedural evaluation of complications. The current paper provides recommendations for pre-procedural and intraprocedural imaging used in assessing patients for transcatheter aortic valve replacement with either balloon-expandable or self-expanding transcatheter heart valves.

Key Words

aortic stenosis
aortic valve
echocardiography
TAVR

Abbreviations and Acronyms

2D
2-dimensional
3D
3-dimensional
BAV
balloon aortic valvuloplasty
EOA
effective orifice area
ICE
intracardiac echocardiography
LVOT
left ventricular outflow tract
MSCT
multislice computed tomography
PAR
paravalvular aortic regurgitation
RVOT
right ventricular outflow tract
TAVR
transcatheter aortic valve replacement
TEE
transesophageal echocardiography
THV
transcatheter heart valve
TTE
transthoracic echocardiography

Cited by (0)

Dr. Hahn has Core Lab contracts with Edwards Lifesciences for which she has received no direct compensation; and is a speaker for Philips Healthcare, St. Jude Medical, and Boston Scientific. Dr. Little has received research funding from Medtronic, as a coinvestigator for the CoreValve Pivotal Extreme risk and high-risk clinical trials, and from St. Jude Medical. Dr. Monaghan is a proctor for Edwards Lifesciences; and is a speaker for Philips Healthcare and GE Medical. Dr. Kodali has received consulting fees from Edwards Lifesciences; and is on the Scientific Advisory Boards of Thubrikar Aortic Valve Inc. and Meril Life Sciences. Dr. Williams receives research funding from Medtronic, as the principal investigator for the Evolut R clinical trial; and is a consultant for Medtronic and Edwards Lifesciences. Dr. Leon is a nonpaid member of the Scientific Advisory Board of Edwards Lifesciences. Dr. Gillam has Core Lab contracts with Medtronic and Edwards Lifesciences (for which she receives no direct compensation).