lWashington University School of Medicine, Saint Louis, Missouri; American Association for Thoracic Surgery. mCleveland Clinic, Cleveland, Ohio. nStanford University, Stanford, California. oMercyhealth, Rockford, Illinois. pSpecialty Chair, Duke University Medical Center, Durham, North Carolina. qSpecialty Chair, Brigham & Women's Hospital, Boston, Massachusetts. The American College of Radiology seeks and encourages collaboration with other organizations on the development of the ACR Appropriateness Criteria through representation of such organizations on expert panels. Participation on the expert panel does not necessarily imply endorsement of the final document by individual contributors or their respective organization. Reprint requests to: publications@acr.org Transcatheter Aortic Valve Replacement Imaging should allow characterization and reporting of aortic valve morphology in each patient and degree of calcification [34,35]. Calcified raphe for bicuspid valves and excess leaflet calcification are known to be associated with an increased risk of procedural complications and midterm mortality [36]. The annulus size for bicuspid aortic valve should be measured and reported in the same fashion as for tricuspid aortic valves, even though the basal attachments of the 2 leaflets of bicuspid aortic valve provide only 2 landmarks out of a necessary 3 landmarks to define an annular plane in space [37]. In addition, it is important to evaluate coronary ostial heights, sinus of Valsalva widths, sinotubular junction diameters, and annular/left ventricular outflow tract (LVOT) calcification, all of which are predictive of complication risks with TAVR. OR Discussion of Procedures by Variant Variant 1: Preintervention planning for transcatheter aortic valve replacement: assessment of aortic root. Initial imaging. Aortography Chest There is no relevant literature to support the use of aortography chest for annulus sizing and assessment of aortic root.
Preprocedural Planning for Transcatheter Aortic Valve Replacement. lWashington University School of Medicine, Saint Louis, Missouri; American Association for Thoracic Surgery. mCleveland Clinic, Cleveland, Ohio. nStanford University, Stanford, California. oMercyhealth, Rockford, Illinois. pSpecialty Chair, Duke University Medical Center, Durham, North Carolina. qSpecialty Chair, Brigham & Women's Hospital, Boston, Massachusetts. The American College of Radiology seeks and encourages collaboration with other organizations on the development of the ACR Appropriateness Criteria through representation of such organizations on expert panels. Participation on the expert panel does not necessarily imply endorsement of the final document by individual contributors or their respective organization. Reprint requests to: publications@acr.org Transcatheter Aortic Valve Replacement Imaging should allow characterization and reporting of aortic valve morphology in each patient and degree of calcification [34,35]. Calcified raphe for bicuspid valves and excess leaflet calcification are known to be associated with an increased risk of procedural complications and midterm mortality [36]. The annulus size for bicuspid aortic valve should be measured and reported in the same fashion as for tricuspid aortic valves, even though the basal attachments of the 2 leaflets of bicuspid aortic valve provide only 2 landmarks out of a necessary 3 landmarks to define an annular plane in space [37]. In addition, it is important to evaluate coronary ostial heights, sinus of Valsalva widths, sinotubular junction diameters, and annular/left ventricular outflow tract (LVOT) calcification, all of which are predictive of complication risks with TAVR. OR Discussion of Procedures by Variant Variant 1: Preintervention planning for transcatheter aortic valve replacement: assessment of aortic root. Initial imaging. Aortography Chest There is no relevant literature to support the use of aortography chest for annulus sizing and assessment of aortic root.