engleski

Echocardiographic assessment for transcatheter aortic valve implantation

Surgical aortic valve replacement (AVR) is the conventional treatment for severe aortic stenosis (AS). Conservative management of patients with severe AS is known to have a poor prognosis and without surgery, the outcome of these patients is also extremely poor. However, with the aging of the population, the number of elderly patients with severe symptomatic AS has grown, and a significant proportion of high-risk patients are not candidate for surgical AVR because of age and comorbidities. Transcatheter aortic valve implantation (TAVI) was developed to address this unmet need. After the demonstration of feasibility of TAVI in 2002, it is now widely practiced, and the technique has been recommended as an alternative strategy for patients in high-risk surgical group. Echocardiography plays important role in anatomical case selection, in procedural guidance, and in the management of complications. 2D and 3D transoesophageal echocardiography (TEE) enable detailed imaging of aortic valve(AV) and aortic root anatomy, measurement of AV annulus dimension, and review of other cardiac and aortic structures. Measurement of the size of the aortic annulus require precise assessment to allow appropriate valve selection and to minimize the risk of paravalvular leak and device migration. Comprehensive postprocedure TEE evaluation is performed following the initial confirmation of satisfactory transcatheter heart valve position and function. Echocardiography plays an essential role in the planning and provision of TAVI for high-risk patients with severe AS, and in combination with other imaging modalities, it allows appropriate case selection, correct choice of prosthetic size and type, guides successful implantation, and facilitates the treatment of complications.

aortic stenosis ; transcatheter aortic valve implantation ; echocardiography

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