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Determinants and Impact of Heart Failure Readmission Following Transcatheter Aortic Valve Replacement Ascending Aortic Length and Risk of Aortic Adverse Events: The Neglected Dimension A Controlled Trial of Rivaroxaban After Transcatheter Aortic-Valve Replacement Change in Kidney Function and 2-Year Mortality After Transcatheter Aortic Valve Replacement Impact of Incomplete Coronary Revascularization on Late Ischemic and Bleeding Events after Transcatheter Aortic Valve Replacement von Willebrand Factor and Management of Heart Valve Disease: JACC Review Topic of the Week Coronary Access After TAVR With a Self-Expanding Bioprosthesis: Insights From Computed Tomography Ambulatory Electrocardiogram Monitoring in Patients Undergoing Transcatheter Aortic Valve Replacement: JACC State-of-the-Art Review Coronary Protection to Prevent Coronary Obstruction During TAVR: A Multicenter International Registry Impact of Pre-Existing and New-Onset Atrial Fibrillation on Outcomes After Transcatheter Aortic Valve Replacement
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Review ArticleVolume 12, Issue 9, September 2019

JOURNAL：J Am Coll Cardiol. ACC Cardiovasc Imaging. Article Link

Why and How to Measure Aortic Valve Calcification in Patients With Aortic Stenosis

T Pawade, T Sheth, E Guzzetti, MR Dweck et al. Keywords: aortic stenosis；aortic valve calcification； computed tomography

ABSTRACT

The first-line evaluation of aortic stenosis severity is Doppler echocardiography. However, in up to 40% of patients, resting echocardiographic assessment of aortic stenosis severity is discordant, leading to clinical uncertainty. Interest has therefore grown in aortic valve calcium scoring by multidetector computed tomography (CT-AVC) as an alternative load independent assessment of aortic stenosis severity. This paper will briefly review the pathophysiology of aortic stenosis and the crucial role that calcification plays in driving progressive obstruction of the valve. Subsequently, it will describe published reports that have investigated CT-AVC, validating this parameter against histology, and establishing its diagnostic accuracy versus echocardiography as well as its powerful independent prognostic capability. Finally, this review seeks to provide a practical guide about how best to acquire and interpret CT-AVC with a close focus on potential pitfalls and how these might be best avoided as this technique becomes more widely adopted in to clinical practice.
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