Cardiac ❯ TAVR
| Problem | Transcatheter aortic valve replacement (TAVR) Protocol study |
| Protocol | The TAVR protocol has to solve many problems and answer many questions in a single exam. We do a gated acquisition of the aortic root up to the arch using thin section CT and follow this with a flash acquisition from the lung apex thru the lower aspect of the symphysis pubis. The gated acquisition is for measurement of the aortic root and valve in order to select the size of the TAVR that is correct for the patient. Vendors like Edwards or Boston Scientific provide software for the proper valve selection. The scanning of the chest and abdomen has several roles including looking at the entire aorta and especially the femoral and iliac vessels to look for the appropriate insertion site. In addition since TAVR patients are older we also look for potential silent tumors ranging from lung cancer to renal cell carcinoma to lymphoma. |
| Pearls | 1. What are the advantages of a TAVR over a classic aortic valve repair? They are typically listed as low rate of serious complications, shorter recovery time, less pain and discomfort, shorter hospital stay and improved quality of life. 2. TAVR require measurements at the aortic root for devise selection 3. Analysis of the iliac vessel for stenosis or excessive plaque is critical 4. The CT report will also address extra vascular pathology especially possible neoplasms. 5. TAVR were initially used in select groups of patients but are now mainstream. |