Evaluation specification of CT images for transapical transcatheter aortic valve replacement_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

MA Yanyan ¹ , LIU Yang ¹ ,  YANG Jian ¹ ,  GUO Yingqiang ² , Writting Group of Evaluation Specification of CT Images for TA-TAVR

1. Department of Cardiovascular Surgery, The First Affiliated Hospital of Air Force Medical University, Xi'an, 710032, P. R. China;
2. Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Chengdu, 610041, P. R. China;

Corresponding author：

YANG Jian, Email: yangjian1212@hotmail.com; GUO Yingqiang, Email: drguoyq@hotmail.com

Keywords：

Transcatheter aortic valve replacement; transapical approach; CT evaluation; 3D printing; evaluation specification

DOI：

10.7507/1007-4848.202302017

Video：

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According to the needs of CT image evaluation for transapical transcatheter aortic valve replacement (TAVR), 20 clinical questions were proposed by the Delphi method, 15 questions were initially determined, and 12 clinical questions were summarized and determined by domestic experts. PubMed, Web of Science, Wanfang, and CNKI databases were searched by computer to collect the relevant literature from inception to November 2022, and finally 53 studies were included. Based on evidence-based study and evaluation experience, 3 meetings were held to give recommendations for preoperative CT data acquisition method, preoperative imaging evaluation of aortic root, imaging evaluation of transapical approach, preoperative auxiliary guidance of TAVR by CT images combined with 3D printing, and postoperative imaging evaluation of transapical TAVR, hoping to promote the standardized and successful development of transapical TAVR in China.

Citation： MA Yanyan, LIU Yang, YANG Jian, GUO Yingqiang, Writting Group of Evaluation Specification of CT Images for TA-TAVR. Evaluation specification of CT images for transapical transcatheter aortic valve replacement. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2023, 30(5): 647-659. doi: 10.7507/1007-4848.202302017 Copy

1.	Strauch J, Wendt D, Diegeler A, et al. Balloon-expandable transapical transcatheter aortic valve implantation with or without predilation of the aortic valve: Results of a multicentre registry. Eur J Cardiothorac Surg, 2018, 53(4): 771-777.
2.	Liu L, Yao X, Peng Y, et al. One-year outcome after transcatheter aortic valve replacement for aortic regurgitation: A single-center study. J Card Surg, 2022, 37(4): 882-892.
3.	Halliburton SS, Abbara S, Chen MY, et al. SCCT guidelines on radiation dose and dose-optimization strategies in cardiovascular CT. J Cardiovasc Comput Tomogr, 2011, 5(4): 198-224.
4.	Holmes DR, Mack MJ, Kaul S, et al. 2012 ACCF/AATS/SCAI/STS expert consensus document on transcatheter aortic valve replacement. J Am Coll Cardiol, 2012, 59(13): 1200-1254.
5.	Suchá D, Tuncay V, Prakken NH, et al. Does the aortic annulus undergo conformational change throughout the cardiac cycle? A systematic review. Eur Heart J Cardiovasc Imaging, 2015, 16(12): 1307-1317.
6.	Jurencak T, Turek J, Kietselaer BL, et al. MDCT evaluation of aortic root and aortic valve prior to TAVI. What is the optimal imaging time point in the cardiac cycle? Eur Radiol, 2015, 25(7): 1975-1983.
7.	Achenbach S, Delgado V, Hausleiter J, et al. SCCT expert consensus document on computed tomography imaging before transcatheter aortic valve implantation (TAVI)/transcatheter aortic valve replacement (TAVR). J Cardiovasc Comput Tomogr, 2012, 6(6): 366-380.
8.	Blanke P, Weir-McCall JR, Achenbach S, et al. Computed tomography imaging in the context of transcatheter aortic valve implantation (TAVI)/transcatheter aortic valve replacement (TAVR): An expert consensus document of the Society of Cardiovascular Computed Tomography. J Cardiovasc Comput Tomogr, 2019, 13(1): 1-20.
9.	中国医师协会心血管内科医师分会结构性心脏病专业委员会. 中国经导管主动脉瓣置换术临床路径专家共识(2021版). 中国循环杂志, 2022, 37(1): 12-23.
10.	杨剑. 经导管主动脉瓣置换 SOP 手册. 北京: 化学工业出版社, 2021. 21-46.
11.	Al-Najafi S, Sanchez F, Lerakis S. The crucial role of cardiac imaging in transcatheter aortic valve replacement (TAVR): Pre- and post-procedural assessment. Curr Treat Options Cardiovasc Med, 2016, 18(12): 70.
12.	Anderson RH. Clinical anatomy of the aortic root. Heart, 2000, 84(6): 670-673.
13.	Piazza N, de Jaegere P, Schultz C, et al. Anatomy of the aortic valvar complex and its implications for transcatheter implantation of the aortic valve. Circ Cardiovasc Interv, 2008, 1(1): 74-81.
14.	Yucel-Finn A, Nicol E, Leipsic JA, et al. CT in planning transcatheter aortic valve implantation procedures and risk assessment. Clin Radiol, 2021, 76(1): 73.e1-73.e19.
15.	Saadi RP, Tagliari AP, Saadi EK, et al. Preoperative TAVR planning: How to do it. J Clin Med, 2022, 11(9): 2582.
16.	Salgado RA, Leipsic JA, Shivalkar B, et al. Preprocedural CT evaluation of transcatheter aortic valve replacement: What the radiologist needs to know. Radiographics, 2014, 34(6): 1491-1514.
17.	Boccalini S, Bons LR, van den Hoven AT, et al. Bicuspid aortic valve annulus: Assessment of geometry and size changes during the cardiac cycle as measured with a standardized method to define the annular plane. Eur Radiol, 2021, 31(11): 8116-8129.
18.	Kasel AM, Cassese S, Bleiziffer S, et al. Standardized imaging for aortic annular sizing: Implications for transcatheter valve selection. JACC Cardiovasc Imaging, 2013, 6(2): 249-262.
19.	Jilaihawi H, Kashif M, Fontana G, et al. Cross-sectional computed tomographic assessment improves accuracy of aortic annular sizing for transcatheter aortic valve replacement and reduces the incidence of paravalvular aortic regurgitation. J Am Coll Cardiol, 2012, 59(14): 1275-1286.
20.	Condado JF, Corrigan FE, Lerakis S, et al. Anatomical risk models for paravalvular leak and landing zone complications for balloon-expandable transcatheter aortic valve replacement. Catheter Cardiovasc Interv, 2017, 90(4): 690-700.
21.	Mauri V, Frohn T, Deuschl F, et al. Impact of device landing zone calcification patterns on paravalvular regurgitation after transcatheter aortic valve replacement with different next-generation devices. Open Heart, 2020, 7(1): e001164.
22.	Akinseye OA, Jha SK, Ibebuogu UN. Clinical outcomes of coronary occlusion following transcatheter aortic valve replacement: A systematic review. Cardiovasc Revasc Med, 2018, 19(2): 229-236.
23.	Ribeiro HB, Sarmento-Leite R, Siqueira DA, et al. Coronary obstruction following transcatheter aortic valve implantation. Arq Bras Cardiol, 2014, 102(1): 93-96.
24.	Maddox TM, Stanislawski MA, Grunwald GK, et al. Nonobstructive coronary artery disease and risk of myocardial infarction. JAMA, 2014, 312(17): 1754-1763.
25.	Levine GN, Bates ER, Blankenship JC, et al. 2011 ACCF/AHA/SCAI guideline for percutaneous coronary intervention. A report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Society for Cardiovascular Angiography and Interventions. J Am Coll Cardiol, 2011, 58(24): e44-e122.
26.	Bettinger N, Khalique OK, Krepp JM, et al. Practical determination of aortic valve calcium volume score on contrast-enhanced computed tomography prior to transcatheter aortic valve replacement and impact on paravalvular regurgitation: Elucidating optimal threshold cutoffs. J Cardiovasc Comput Tomogr, 2017, 11(4): 302-308.
27.	Tops LF, Wood DA, Delgado V, et al. Noninvasive evaluation of the aortic root with multislice computed tomography implications for transcatheter aortic valve replacement. JACC Cardiovasc Imaging, 2008, 1(3): 321-330.
28.	Généreux P, Head SJ, Van Mieghem NM, et al. Clinical outcomes after transcatheter aortic valve replacement using valve academic research consortium definitions: A weighted meta-analysis of3, 519 patients from 16 studies. J Am Coll Cardiol, 2012, 59(25): 2317-2326.
29.	Miki T, Senoo K, Ohkura T, et al. Importance of preoperative computed tomography assessment of the membranous septal anatomy in patients undergoing transcatheter aortic valve replacement with a balloon-expandable valve. Circ J, 2020, 84(2): 269-276.
30.	Zhu L, Guo Y, Wang W, et al. Transapical transcatheter aortic valve replacement with a novel transcatheter aortic valve replacement system in high-risk patients with severe aortic valve diseases. J Thorac Cardiovasc Surg, 2018, 155(2): 588-597.
31.	Treede H, Mohr FW, Baldus S, et al. Transapical transcatheter aortic valve implantation using the JenaValve™ system: Acute and 30-day results of the multicentre CE-mark study. Eur J Cardiothorac Surg, 2012, 41(6): e131-e138.
32.	Shi J, Wei L, Chen Y, et al. Transcatheter aortic valve implantation with J-valve: 2-year outcomes from a multicenter study. Ann Thorac Surg, 2021, 111(5): 1530-1536.
33.	Mehier B, Dubourg B, Eltchaninoff H, et al. MDCT planning of trans catheter aortic valve implantation (TAVI): Determination of optimal c-arm angulation. Int J Cardiovasc Imaging, 2020, 36(8): 1551-1557.
34.	Ben-Shoshan J, Alosaimi H, Lauzier PT, et al. Double S-curve versus cusp-overlap technique: Defining the optimal fluoroscopic projection for TAVR with a self-expanding device. JACC Cardiovasc Interv, 2021, 14(2): 185-194.
35.	Tchétché D, Siddiqui S. Optimizing fluoroscopic projections for TAVR: Any difference between the double S-curve and the cusp-overlap technique? JACC Cardiovasc Interv, 2021, 14(2): 195-197.
36.	Wang DD, Qian Z, Vukicevic M, et al. 3D printing, computational modeling, and artificial intelligence for structural heart disease. JACC Cardiovasc Imaging, 2021, 14(1): 41-60.
37.	杨剑. 心血管 3D 打印技术. 北京: 化学工业出版社, 2020. 61-183.
38.	Haghiashtiani G, Qiu K, Zhingre Sanchez JD, et al. 3D printed patient-specific aortic root models with internal sensors for minimally invasive applications. Sci Adv, 2020, 6(35): eabb4641.
39.	Vukicevic M, Mosadegh B, Min JK, et al. Cardiac 3D printing and its future directions. JACC Cardiovasc Imaging, 2017, 10(2): 171-184.
40.	杨剑. 3D 打印技术在经导管主动脉瓣置换术中的应用与实践. 北京: 化学工业出版社, 2021. 119-280.
41.	马燕燕, 毛予, 刘洋, 等. 3D打印指导经导管主动脉瓣置换术的多中心回顾性研究. 中国循环杂志, 2022, 37(4): 348-355.
42.	Ripley B, Kelil T, Cheezum MK, et al. 3D printing based on cardiac CT assists anatomic visualization prior to transcatheter aortic valve replacement. J Cardiovasc Comput Tomogr, 2016, 10(1): 28-36.
43.	Ma Y, Mao Y, Zhu G, et al. Application of cardiovascular 3-dimensional printing in transcatheter aortic valve replacement. Cell Regen, 2022, 11(1): 35.
44.	So CY, Fan Y, Wu EB, et al. Anticipating coronary obstruction with three-dimensional printing in transcatheter aortic valve implantation. EuroIntervention, 2020, 15(16): 1424-1425.
45.	Ma Y, Ding P, Li L, et al. Three-dimensional printing for heart diseases: Clinical application review. Biodes Manuf, 2021, 4(3): 675-687.
46.	Thorburn C, Abdel-Razek O, Fagan S, et al. Three-dimensional printing for assessment of paravalvular leak in transcatheter aortic valve implantation. J Cardiothorac Surg, 2020, 15(1): 211.
47.	Qian Z, Wang K, Liu S, et al. Quantitative prediction of paravalvular leak in transcatheter aortic valve replacement based on tissue-mimicking 3D printing. JACC Cardiovasc Imaging, 2017, 10(7): 719-731.
48.	Sammour Y, Krishnaswamy A, Kumar A, et al. Incidence, predictors, and implications of permanent pacemaker requirement after transcatheter aortic valve replacement. JACC Cardiovasc Interv, 2021, 14(2): 115-134.
49.	Rocatello G, El Faquir N, De Santis G, et al. Patient-specific computer simulation to elucidate the role of contact pressure in the development of new conduction abnormalities after catheter-based implantation of a self-expanding aortic valve. Circ Cardiovasc Interv, 2018, 11(2): e005344.
50.	Andrews JPM, Cartlidge TR, Dweck MR, et al. Cardiac CT in prosthetic aortic valve complications. Br J Radiol, 2019, 92(1093): 20180237.
51.	Marwan M, Mekkhala N, Göller M, et al. Leaflet thrombosis following transcatheter aortic valve implantation. J Cardiovasc Comput Tomogr, 2018, 12(1): 8-13.
52.	Jilaihawi H, Asch FM, Manasse E, et al. Systematic CT methodology for the evaluation of subclinical leaflet thrombosis. JACC Cardiovasc Imaging, 2017, 10(4): 461-470.

1. Strauch J, Wendt D, Diegeler A, et al. Balloon-expandable transapical transcatheter aortic valve implantation with or without predilation of the aortic valve: Results of a multicentre registry. Eur J Cardiothorac Surg, 2018, 53(4): 771-777.
2. Liu L, Yao X, Peng Y, et al. One-year outcome after transcatheter aortic valve replacement for aortic regurgitation: A single-center study. J Card Surg, 2022, 37(4): 882-892.
3. Halliburton SS, Abbara S, Chen MY, et al. SCCT guidelines on radiation dose and dose-optimization strategies in cardiovascular CT. J Cardiovasc Comput Tomogr, 2011, 5(4): 198-224.
4. Holmes DR, Mack MJ, Kaul S, et al. 2012 ACCF/AATS/SCAI/STS expert consensus document on transcatheter aortic valve replacement. J Am Coll Cardiol, 2012, 59(13): 1200-1254.
5. Suchá D, Tuncay V, Prakken NH, et al. Does the aortic annulus undergo conformational change throughout the cardiac cycle? A systematic review. Eur Heart J Cardiovasc Imaging, 2015, 16(12): 1307-1317.
6. Jurencak T, Turek J, Kietselaer BL, et al. MDCT evaluation of aortic root and aortic valve prior to TAVI. What is the optimal imaging time point in the cardiac cycle? Eur Radiol, 2015, 25(7): 1975-1983.
7. Achenbach S, Delgado V, Hausleiter J, et al. SCCT expert consensus document on computed tomography imaging before transcatheter aortic valve implantation (TAVI)/transcatheter aortic valve replacement (TAVR). J Cardiovasc Comput Tomogr, 2012, 6(6): 366-380.
8. Blanke P, Weir-McCall JR, Achenbach S, et al. Computed tomography imaging in the context of transcatheter aortic valve implantation (TAVI)/transcatheter aortic valve replacement (TAVR): An expert consensus document of the Society of Cardiovascular Computed Tomography. J Cardiovasc Comput Tomogr, 2019, 13(1): 1-20.
9. 中国医师协会心血管内科医师分会结构性心脏病专业委员会. 中国经导管主动脉瓣置换术临床路径专家共识(2021版). 中国循环杂志, 2022, 37(1): 12-23.
10. 杨剑. 经导管主动脉瓣置换 SOP 手册. 北京: 化学工业出版社, 2021. 21-46.
11. Al-Najafi S, Sanchez F, Lerakis S. The crucial role of cardiac imaging in transcatheter aortic valve replacement (TAVR): Pre- and post-procedural assessment. Curr Treat Options Cardiovasc Med, 2016, 18(12): 70.
12. Anderson RH. Clinical anatomy of the aortic root. Heart, 2000, 84(6): 670-673.
13. Piazza N, de Jaegere P, Schultz C, et al. Anatomy of the aortic valvar complex and its implications for transcatheter implantation of the aortic valve. Circ Cardiovasc Interv, 2008, 1(1): 74-81.
14. Yucel-Finn A, Nicol E, Leipsic JA, et al. CT in planning transcatheter aortic valve implantation procedures and risk assessment. Clin Radiol, 2021, 76(1): 73.e1-73.e19.
15. Saadi RP, Tagliari AP, Saadi EK, et al. Preoperative TAVR planning: How to do it. J Clin Med, 2022, 11(9): 2582.
16. Salgado RA, Leipsic JA, Shivalkar B, et al. Preprocedural CT evaluation of transcatheter aortic valve replacement: What the radiologist needs to know. Radiographics, 2014, 34(6): 1491-1514.
17. Boccalini S, Bons LR, van den Hoven AT, et al. Bicuspid aortic valve annulus: Assessment of geometry and size changes during the cardiac cycle as measured with a standardized method to define the annular plane. Eur Radiol, 2021, 31(11): 8116-8129.
18. Kasel AM, Cassese S, Bleiziffer S, et al. Standardized imaging for aortic annular sizing: Implications for transcatheter valve selection. JACC Cardiovasc Imaging, 2013, 6(2): 249-262.
19. Jilaihawi H, Kashif M, Fontana G, et al. Cross-sectional computed tomographic assessment improves accuracy of aortic annular sizing for transcatheter aortic valve replacement and reduces the incidence of paravalvular aortic regurgitation. J Am Coll Cardiol, 2012, 59(14): 1275-1286.
20. Condado JF, Corrigan FE, Lerakis S, et al. Anatomical risk models for paravalvular leak and landing zone complications for balloon-expandable transcatheter aortic valve replacement. Catheter Cardiovasc Interv, 2017, 90(4): 690-700.
21. Mauri V, Frohn T, Deuschl F, et al. Impact of device landing zone calcification patterns on paravalvular regurgitation after transcatheter aortic valve replacement with different next-generation devices. Open Heart, 2020, 7(1): e001164.
22. Akinseye OA, Jha SK, Ibebuogu UN. Clinical outcomes of coronary occlusion following transcatheter aortic valve replacement: A systematic review. Cardiovasc Revasc Med, 2018, 19(2): 229-236.
23. Ribeiro HB, Sarmento-Leite R, Siqueira DA, et al. Coronary obstruction following transcatheter aortic valve implantation. Arq Bras Cardiol, 2014, 102(1): 93-96.
24. Maddox TM, Stanislawski MA, Grunwald GK, et al. Nonobstructive coronary artery disease and risk of myocardial infarction. JAMA, 2014, 312(17): 1754-1763.
25. Levine GN, Bates ER, Blankenship JC, et al. 2011 ACCF/AHA/SCAI guideline for percutaneous coronary intervention. A report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Society for Cardiovascular Angiography and Interventions. J Am Coll Cardiol, 2011, 58(24): e44-e122.
26. Bettinger N, Khalique OK, Krepp JM, et al. Practical determination of aortic valve calcium volume score on contrast-enhanced computed tomography prior to transcatheter aortic valve replacement and impact on paravalvular regurgitation: Elucidating optimal threshold cutoffs. J Cardiovasc Comput Tomogr, 2017, 11(4): 302-308.
27. Tops LF, Wood DA, Delgado V, et al. Noninvasive evaluation of the aortic root with multislice computed tomography implications for transcatheter aortic valve replacement. JACC Cardiovasc Imaging, 2008, 1(3): 321-330.
28. Généreux P, Head SJ, Van Mieghem NM, et al. Clinical outcomes after transcatheter aortic valve replacement using valve academic research consortium definitions: A weighted meta-analysis of3, 519 patients from 16 studies. J Am Coll Cardiol, 2012, 59(25): 2317-2326.
29. Miki T, Senoo K, Ohkura T, et al. Importance of preoperative computed tomography assessment of the membranous septal anatomy in patients undergoing transcatheter aortic valve replacement with a balloon-expandable valve. Circ J, 2020, 84(2): 269-276.
30. Zhu L, Guo Y, Wang W, et al. Transapical transcatheter aortic valve replacement with a novel transcatheter aortic valve replacement system in high-risk patients with severe aortic valve diseases. J Thorac Cardiovasc Surg, 2018, 155(2): 588-597.
31. Treede H, Mohr FW, Baldus S, et al. Transapical transcatheter aortic valve implantation using the JenaValve™ system: Acute and 30-day results of the multicentre CE-mark study. Eur J Cardiothorac Surg, 2012, 41(6): e131-e138.
32. Shi J, Wei L, Chen Y, et al. Transcatheter aortic valve implantation with J-valve: 2-year outcomes from a multicenter study. Ann Thorac Surg, 2021, 111(5): 1530-1536.
33. Mehier B, Dubourg B, Eltchaninoff H, et al. MDCT planning of trans catheter aortic valve implantation (TAVI): Determination of optimal c-arm angulation. Int J Cardiovasc Imaging, 2020, 36(8): 1551-1557.
34. Ben-Shoshan J, Alosaimi H, Lauzier PT, et al. Double S-curve versus cusp-overlap technique: Defining the optimal fluoroscopic projection for TAVR with a self-expanding device. JACC Cardiovasc Interv, 2021, 14(2): 185-194.
35. Tchétché D, Siddiqui S. Optimizing fluoroscopic projections for TAVR: Any difference between the double S-curve and the cusp-overlap technique? JACC Cardiovasc Interv, 2021, 14(2): 195-197.
36. Wang DD, Qian Z, Vukicevic M, et al. 3D printing, computational modeling, and artificial intelligence for structural heart disease. JACC Cardiovasc Imaging, 2021, 14(1): 41-60.
37. 杨剑. 心血管 3D 打印技术. 北京: 化学工业出版社, 2020. 61-183.
38. Haghiashtiani G, Qiu K, Zhingre Sanchez JD, et al. 3D printed patient-specific aortic root models with internal sensors for minimally invasive applications. Sci Adv, 2020, 6(35): eabb4641.
39. Vukicevic M, Mosadegh B, Min JK, et al. Cardiac 3D printing and its future directions. JACC Cardiovasc Imaging, 2017, 10(2): 171-184.
40. 杨剑. 3D 打印技术在经导管主动脉瓣置换术中的应用与实践. 北京: 化学工业出版社, 2021. 119-280.
41. 马燕燕, 毛予, 刘洋, 等. 3D打印指导经导管主动脉瓣置换术的多中心回顾性研究. 中国循环杂志, 2022, 37(4): 348-355.
42. Ripley B, Kelil T, Cheezum MK, et al. 3D printing based on cardiac CT assists anatomic visualization prior to transcatheter aortic valve replacement. J Cardiovasc Comput Tomogr, 2016, 10(1): 28-36.
43. Ma Y, Mao Y, Zhu G, et al. Application of cardiovascular 3-dimensional printing in transcatheter aortic valve replacement. Cell Regen, 2022, 11(1): 35.
44. So CY, Fan Y, Wu EB, et al. Anticipating coronary obstruction with three-dimensional printing in transcatheter aortic valve implantation. EuroIntervention, 2020, 15(16): 1424-1425.
45. Ma Y, Ding P, Li L, et al. Three-dimensional printing for heart diseases: Clinical application review. Biodes Manuf, 2021, 4(3): 675-687.
46. Thorburn C, Abdel-Razek O, Fagan S, et al. Three-dimensional printing for assessment of paravalvular leak in transcatheter aortic valve implantation. J Cardiothorac Surg, 2020, 15(1): 211.
47. Qian Z, Wang K, Liu S, et al. Quantitative prediction of paravalvular leak in transcatheter aortic valve replacement based on tissue-mimicking 3D printing. JACC Cardiovasc Imaging, 2017, 10(7): 719-731.
48. Sammour Y, Krishnaswamy A, Kumar A, et al. Incidence, predictors, and implications of permanent pacemaker requirement after transcatheter aortic valve replacement. JACC Cardiovasc Interv, 2021, 14(2): 115-134.
49. Rocatello G, El Faquir N, De Santis G, et al. Patient-specific computer simulation to elucidate the role of contact pressure in the development of new conduction abnormalities after catheter-based implantation of a self-expanding aortic valve. Circ Cardiovasc Interv, 2018, 11(2): e005344.
50. Andrews JPM, Cartlidge TR, Dweck MR, et al. Cardiac CT in prosthetic aortic valve complications. Br J Radiol, 2019, 92(1093): 20180237.
51. Marwan M, Mekkhala N, Göller M, et al. Leaflet thrombosis following transcatheter aortic valve implantation. J Cardiovasc Comput Tomogr, 2018, 12(1): 8-13.
52. Jilaihawi H, Asch FM, Manasse E, et al. Systematic CT methodology for the evaluation of subclinical leaflet thrombosis. JACC Cardiovasc Imaging, 2017, 10(4): 461-470.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Evaluation specification of CT images for transapical transcatheter aortic valve replacement

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