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Computed tomography angiography-derived extracellular volume fraction predicts early recovery of left ventricular systolic function after transcatheter aortic valve replacement Randomized Evaluation of TriGuard 3 Cerebral Embolic Protection After Transcatheter Aortic Valve Replacement: REFLECT II Impact of Pre-Existing and New-Onset Atrial Fibrillation on Outcomes After Transcatheter Aortic Valve Replacement von Willebrand Factor and Management of Heart Valve Disease: JACC Review Topic of the Week Thrombotic Versus Bleeding Risk After Transcatheter Aortic Valve Replacement: JACC Review Topic of the Week Long-term health outcome and mortality evaluation after invasive coronary treatment using drug eluting stents with or without the IVUS guidance. Randomized control trial. HOME DES IVUS Left Ventricular Rapid Pacing Via the Valve Delivery Guidewire in Transcatheter Aortic Valve Replacement Impact of Intravascular Ultrasound on Long-Term Clinical Outcomes in Patients With Acute Myocardial Infarction Impact of intravascular ultrasound guidance in routine percutaneous coronary intervention for conventional lesions: data from the EXCELLENT trial Contemporary Use and Trends in Unprotected Left Main Coronary Artery Percutaneous Coronary Intervention in the United States: An Analysis of the National Cardiovascular Data Registry Research to Practice Initiative
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JOURNAL：ACC Article Link

TAVR: Role of Multimodality Imaging

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The following are key points to remember from this state-of-the-art review on transcatheter aortic valve replacement (TAVR) and the role of multimodality imaging in common and complex clinical scenarios:

  1. 1. TAVR has rapidly become an established therapy for patients with symptomatic severe aortic stenosis (AS).
  2. 2. Technological advances and the learning curve have resulted in better procedural results in terms of hemodynamic valve performance and intermediate-term clinical outcomes.
  3. 3. 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.
  4. 4. The use of 3D imaging techniques (multi-detector row computed tomography [MDCT], cardiac magnetic resonance [CMR], and 3D echocardiography) that permit accurate measurement of the left ventricular outflow tract area by direct planimetry has demonstrated the ability to reclassify severe AS patients into moderate AS by 12% in patients with low-flow, low-gradient severe AS.
  5. 5. 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.
  6. 6. The use of both echocardiography and MDCT is key in the diagnosis of patients with severe AS who may benefit from TAVR as well as in the procedural planning and evaluation of the results at follow-up.
  7. 7. The number of patients with bicuspid AS treated with TAVR is increasing and the TAVR results with the use of new generation prostheses are promising.
  8. 8. TAVR in degenerated bioprosthesis has been an important recent breakthrough because re-operation in these individuals is associated with very high mortality.
  9. 9. Patients with native aortic regurgitation are also now being treated with TAVR.
  10. 10. These newer indications for TAVR need careful imaging evaluation of the anatomy of the landing zone to ensure successful anchoring of the TAVR prosthesis and to minimize complications. These new horizons for TAVR are making multimodality imaging critically important for this evolving therapy.

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