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Frequency of nonsystem delays in ST-elevation myocardial infarction patients undergoing primary percutaneous coronary intervention and implications for door-to-balloon time reporting (from the American Heart Association Mission: Lifeline program) Radial Versus Femoral Access for Coronary Interventions Across the Entire Spectrum of Patients With Coronary Artery Disease: A Meta-Analysis of Randomized Trials 2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes: The Task Force for the diagnosis and management of chronic coronary syndromes of the European Society of Cardiology (ESC) Surgical or Transcatheter Aortic-Valve Replacement in Intermediate-Risk Patients Incidence and prognostic implication of unrecognized myocardial scar characterized by cardiac magnetic resonance in diabetic patients without clinical evidence of myocardial infarction Red Cell Distribution Width in Patients with Diabetes and Myocardial Infarction: an analysis from the EXAMINE trial The HACD4 haplotype as a risk factor for atherosclerosis in males The Impact of Proximal Vessel Tortuosity on the Outcomes of Chronic Total Occlusion Percutaneous Coronary Intervention: Insights From a Contemporary Multicenter Registry Changes in One-Year Mortality in Elderly Patients Admitted with Acute Myocardial Infarction in Relation with Early Management De-escalation of antianginal medications after successful chronic total occlusion percutaneous coronary intervention: Frequency and relationship with health status
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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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