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Challenges in the use of imaging in transcatheter aortic valve implantation

Session presentations
Non-invasive Imaging: Echocardiography

In the session “Challenges in the use of imaging in transcatheter aortic valve implantation” the focus was on echocardiographic assessment.

V. Delgado spoke about patient selection. Echo can give us important information about aortic valve anatomy (bicuspid vs. tricuspid valve). Aortic valve stenosis severity is crucial to define the procedure and has specific potential errors in left ventricular outflow tract (LVOT) measurements and in LV systolic dysfunction. Echo also gives us information about aortic annulus dimensions, which is relevant to choose the dimensions of the prosthesis and aortic valve calcifications.

L. Gillam presented the flow characteristics of transcatheter aortic valves. Their take home messages were that these flow characteristics differ from those of conventional surgical bioprostheses. These differences translate to important considerations in the assessment of valve function (gradients and effective orifice area) and assessing these parameters correctly is essential in the ongoing evaluation of these valves.

F. Bauer presented the procedural complications visible by echo, especially paravalvular leak and AVA ≤1.2 cm2. Others are cardiac tamponade, need for valve in valve and valve embolization. Aortic dissection and rupture, coronary obstruction, endocarditis, annulus rupture and LV perforation are rare. Echo is important to prevent these complications and to treat them when they occur.

A. Gonçalvez showed an integrated approach to paravalvular regurgitation, the most frequent complication with important association with adverse events in the follow-up. She underlined the importance of 3D-Echo in the evaluation of the regurgitation.

This was a very well documented and actualized session about the use of echo in the selection, the procedure and the follow-up of patients with TAVI.




Challenges in the use of imaging in transcatheter aortic valve implantation

The content of this article reflects the personal opinion of the author/s and is not necessarily the official position of the European Society of Cardiology.