APRIL - 202219CT AND MR PLANNING FOR MINI INVASIVE APPROACH OF AORTIC VALVE AND MITRAL VALVEGiuseppe Muscogiuri, MD, PhD, FSCCT; Director Cardiovascular Radiology, IstitutoAuxologico Italiano, IRCCS, Milan Italy; Assistant Professor of Radiology, University of Milan-Bicocca, Milan, ItalyByCT AND MR IMAGE OF THE AORTIC VALVEFollowing the new ESC guidelines it seems extremely important the key role of "Heart Team" for planning the perfect surgical approach. The Heart Team, in selected cases, in patients that cannot bear the open surgery,suggest the percutaneous mini-invasive approach as a good compromise for aortic and mitral valve repairment.Nowadays the pre-procedural planning of percutaneous mini-invasive surgery is strictly dependent by the acquisition of CT and MR. Both these techniques provide a comprehensive evaluation of valve anatomy, coronary arteries and vascular access; these CT findings provide a pivotal rule for the correct planning of surgery. In patients that should undergo to transcatheter aortic valve replacement (TAVR) the role of CT is fundamental for the evaluation of aortic anulus, calcification of the aortic valve, coronary arteries and vascular access. The evaluation of aortic anulus can provide pivotal information regarding the sizing of the prosthetic aortic valve furthermore the calcification of the valve can have an important impact for expansion of the implanted valve. The evaluation of coronary artery in patients with TAVR can be extremely important in order to avoid the unnecessary invasive coronary angiography (ICA), considering the powerful rule-out ability of cardiac computed tomography angiography (CCTA) for presence of coronary artery disease. Furthermore, in patients candidated for TAVR the simultaneous acquisition of CT angiography during the acquisition of CCTA can be extremely important for the evaluation of arterial access for the presence of kinking, coiling CXO insights
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