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Bench testing and coronary artery bifurcations: a consensus document from the European Bifurcation Club The Relation Between Optical Coherence Tomography-Detected Layered Pattern and Acute Side Branch Occlusion After Provisional Stenting of Coronary Bifurcation Lesions Validation of bifurcation DEFINITION criteria and comparison of stenting strategies in true left main bifurcation lesions Gut microbiota induces high platelet response in patients with ST segment elevation myocardial infarction after ticagrelor treatment Nicotine promotes vascular calcification via intracellular Ca21-mediated, Nox5-induced oxidative stress, and extracellular vesicle release in vascular smooth muscle cells Will Pulmonary Artery Denervation Really Have a Place in the Armamentarium of the Pulmonary Hypertension Specialist? Evolving understanding of the heterogeneous natural history of individual coronary artery plaques and the role of local endothelial shear stress Patient and Hospital Characteristics of Mitral Valve Surgery in the United States Predictors of Left Main Coronary Artery Disease in the ISCHEMIA Trial Relationship between fractional flow reserve value and the amount of subtended myocardium

Review ArticleVolume 13, Issue 1 Part 1, January 2020

JOURNAL:JACC: Cardiovascular Imaging Article Link

Transcatheter Aortic Valve Replacement: Role of Multimodality Imaging in Common and Complex Clinical Scenarios

JJ Bax, V Delgado, RT Hahn et al. Keywords: aortic regurgitation; bicuspid aortic valve; echocardiography; multi-detector row computed tomography; TAVR

ABSTRACT


Transcatheter aortic valve replacement (TAVR) is an established therapy for patients with symptomatic severe aortic stenosis. Technological advances and the learning curve have resulted in better procedural results in terms of hemodynamic valve performance and intermediate-term clinical outcomes. The integration of anatomical and functional information provided by multimodality imaging has improved size selection of TAVR prostheses, permitted better patient selection, and provided new insights in the performance of the TAVR prostheses at follow-up. Furthermore, the field of TAVR continues to develop and expand the technique to younger patients with lower risk on the one hand, and more complex clinical scenarios, on the other hand, such as degenerated aortic bioprostheses, bicuspid aortic valves, or pure native aortic regurgitation. The present review article summarizes how multimodality imaging can be integrated in TAVR in clinical (sometimes complex) scenarios that have not been included in the landmark randomized clinical trials.