TableĀ 9

Pertinent Components of a Comprehensive Pre-TAVR/TAVI CT Report

CategoryItems
Aortic root findings
  • 1. Valve morphology [tricuspid, congenital bicuspid according to e.g., Sievers classification, functional/acquired bicuspid]

  • 2. Calcium distribution [symmetric, asymmetric, bulky, bulky at free edge]

  • 3. Aortic annular dimension

    • a. Overall image quality [good, fair, poor]

    • b. When assessed (systole/diastole, reconstruction phase)

    • c. Annular area [mm2]

    • d. Annular perimeter [mm]

    • e. Optional min and max diameter [mm]

  • 4. Presence of annular and subannular calcification

    • a. Extent [crescent non-protruding vs. bulky protruding, intramural]

    • b. Location

  • 5. LM height [mm]

  • 6. RCA height [mm]

  • 7. SoV averaged [mm]

  • 8. STJ [mm], report if calcified

  • 9. Optimal coplanar projection [LAO/RAO and corresponding CRA/CAU angulation]

Aorto/ilio/femoral vasculature
  • 1. Pathologies of the ascending aorta

  • 2. Pathologies of the aortic arch, descending thoracic/abdominal aorta

  • 3. Iliofemoral vasculature

    • a. Minimal diameters with location

    • b. Extent [mild, moderate, severe] and location of calcification/plaque; particular emphasis on horse-shoe, circumferential pattern

    • c. Tortuosity

  • 4. Common femoral artery access site

    • a. Calcium (posterior, anterior; anterior has implication for closure system)

    • b. Report findings in regard to the level of the femoral head (upper third, center, lower third)

    • c. Level of femoral bifurcation if at level of femoral head

  • 1. Subclavian artery

    • a. Minimal diameter

    • b. Calcification, in particular at ostium

    • c. Tortuosity

  • 2. Other access approaches such as trans-aortic, trans-carotid or trans-caval depending on site preferences

Other cardiac findingsReport relevant cardiac findings, such as chamber size, myocardial scar, evidence of other valvulopathies including MAC
Other findingsReport relevant extra-cardiac pathologies and relevant incidental findings
Impression
  • 1. Valve morphology, annular area, relevant root features (e.g., adverse root features such as calcification, low coronary artery height, non-spacious sinus of Valsalva)

  • 2. Comment on feasibility of trans-femoral access; adverse features such as horse-shoe/circumferential calcium, severe tortuosity, anterior common femoral artery calcium

  • 3. Relevant incidental findings.