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C-3107 - Risk factors for failed systolic acquisitions in ECG synchronised high-pitch CT-angiographies for TAVR planning

A. Baumann, K. S. Winter, R. Schinner, C. Trumm, F. Schwarz; Munich/DE Type: Scientific Exhibit
Area of Interests: Cardiac, Vascular, Cardiovascular system
Imaging Techniques: CT, CT-Angiography
Procedures: Diagnostic procedure, Outcomes analysis, Audit and standards
Special Focus: Quality assurance
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Aims and objectives: There is substantial evidence demonstrating the importance of systolic phase acquisitions in CT angiographies of the heart for TAVR planning due to the configurational change of the aortic annulus during the cardiac cycle. The purpose of this study was to define risk factors associated with an unsuc[...]

Methods and materials: We evaluated 225 consecutive patients scanned between August and December of 2015 who underwent an ECG-synchronized high-pitch CT-angiography of the thorax and abdomen for TAVR-Planning with an intended systolic acquisition window for the heart at 20% of the RR cycle. Configuration of the aortic val[...]

Results: 32 patients were excluded due to a failure to archive ECG-protocols and another 18 patients for various reasons including valvular anomalies. In the remaining 175 patients systolic phase acquisition was successful in 58,9% (103/175), but failed in 41,1% (72/175). Among systolic datasets the aortic a[...]

Conclusion: Among unselected patients scheduled for TAVR, a high-pitch systolic CTA scan intending systolic acquisition of the annulus is successful in only 59% of cases. High HR and HRV as well as the presence of AF had highly significant predictive value for an unsuccessful systolic phase acquisition and[...]

Personal information: A.B. Baumann, Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital Munich K.S. Winter, Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital Munich R. Schinner, Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital Munich C. Trumm, Institute [...]

References: Smith CR, Leon MB, Mack MJ, et al. Transcatheter versus surgical aortic valve replacement in high-risk patients. N Engl J Med. 2011;364(23):2187-2198.   Blanke P, Russe M, Leipsic J, et al. Conformational pulsatile changes of the aortic annulus: impact on prosthesis sizing by computed tomograph[...]

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