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C-1351 - ECG-Gated dual Pitch CT Angiography for vessel evaluation prior to Transcatheter Aortic Valve Implant (TAVI).

E. Macchi, F. Piacentino, A. Maccaferri, M. Mangini, C. Fugazzola; Varese/IT Type: Educational Exhibit
Area of Interests: Arteries / Aorta, Cardiovascular system, Vascular
Imaging Technique: CT-Angiography
Procedures: Angioplasty, Computer Applications-3D
Special Focus: Hemodynamics / Flow dynamics
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Learning objectives: The purpose of this exhibit is demonstrate the usefulness of ECG-Gated Dual Pitch CT Angiography (DP-CTA) in pre-operative planning for transcatheter aortic valve implantation (TAVI) procedure.

Background: Aortic stenosis is the most frequent cardiac valvular pathology (5% of patients older than 75) and it's defined as obstruction of the left ventricule outflow tract (LVOT) causing a trans-valvular jet with a velocity >400 cm/s, a gradient of about 50mmHg e a valvular area < 1 cm2; critical sten[...]

Findings and procedure details: In Our Institution Patients undergo a CT scan (64 slice MDCT) with Dual Pitch technique: this scan includes a low pitch retrospective ECG gated scan on chest region and a higher pitch non ECG-gated scan on abdomen and proximal femoral axis (Fig.1). Inclusion criteria for this kind of diagnostic proc[...]

Conclusion: This technique provides correct systo-diastolc evaluations of ascending aorta, aortic root structures and peripheric arteries, useful for a correct pre-procedural planning, and for the choice of the best arterial access and of a valvular device with a proper size and morphology.

Personal information: Edoardo Macchi MD Diagnostic Radiology Residency Program University of Insubria Circolo Hospital and Macchi Foundation Via Guicciardini, 9 - 21100 Varese, Italy ‚Äče-mail: e.macchi4@uninsubria.it

References: Salgado RA, et al. Preprocedural CT evaluation of transcatheter aortic valve replacement: what the radiologist needs to know. Radiographics. 2015 Jan-Feb;35(1):299. Leipsic J, et al. The evolving role of MDCT in transcatheter aortic valve replacement: a radiologists' perspec[...]

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