TY - JOUR
T1 - Utility of CT and MRI in Tricuspid Valve Interventions
AU - Rajiah, Prabhakar Shantha
AU - Reddy, Prajwal
AU - Baliyan, Vinit
AU - Hedgire, Sandeep S.
AU - Foley, Thomas A.
AU - Williamson, Eric E.
AU - Eleid, Mackram F.
N1 - Publisher Copyright:
© RSNA, 2023.
PY - 2023
Y1 - 2023
N2 - Transcatheter tricuspid valve interventions (TTVIs) comprise a variety of catheter-based interventional techniques for treatment of tricuspid regurgitation (TR) in patients at high surgical risk and those with failed previous surgeries. Several TTVI devices with different mechanisms of action are either currently used or in preclinical evaluation. Echocardiography is the first-line modality for evaluation of tricuspid valve disease that provides information on tricuspid valve morphology, mechanism of TR, and hemody-namics. Cardiac CT and MRI have several advantages for a comprehensive preprocedure evaluation. CT and MRI provide comple-mentary information to that of echocardiography on the mechanism and cause of TR. MRI can quantify the severity of TR using indirect or direct techniques that involve two-dimensional or four-dimensional flow sequences. MRI and CT can also accurately quantify right ventricular volumes and function, which is crucial for timing of intervention. CT provides comprehensive three-di-mensional information on the morphology of the valve, annulus, subvalvular apparatus, and adjacent structures. CT is the procedure of choice for evaluation of several device-specific measurements, including tricuspid annulus dimensions, annulus-to–right coronary artery distance, leaflet morphology, coaptation gaps, caval dimensions, and cavoatrial-to–hepatic vein distance. CT allows evaluation of the vascular access as well as optimal procedure fluoroscopic angles and catheter trajectory. Postprocedure CT and MRI are useful in detection of complications such as paravalvular leak, pseudoaneurysm, thrombus, pannus, infective endocardi-tis, and device migration.
AB - Transcatheter tricuspid valve interventions (TTVIs) comprise a variety of catheter-based interventional techniques for treatment of tricuspid regurgitation (TR) in patients at high surgical risk and those with failed previous surgeries. Several TTVI devices with different mechanisms of action are either currently used or in preclinical evaluation. Echocardiography is the first-line modality for evaluation of tricuspid valve disease that provides information on tricuspid valve morphology, mechanism of TR, and hemody-namics. Cardiac CT and MRI have several advantages for a comprehensive preprocedure evaluation. CT and MRI provide comple-mentary information to that of echocardiography on the mechanism and cause of TR. MRI can quantify the severity of TR using indirect or direct techniques that involve two-dimensional or four-dimensional flow sequences. MRI and CT can also accurately quantify right ventricular volumes and function, which is crucial for timing of intervention. CT provides comprehensive three-di-mensional information on the morphology of the valve, annulus, subvalvular apparatus, and adjacent structures. CT is the procedure of choice for evaluation of several device-specific measurements, including tricuspid annulus dimensions, annulus-to–right coronary artery distance, leaflet morphology, coaptation gaps, caval dimensions, and cavoatrial-to–hepatic vein distance. CT allows evaluation of the vascular access as well as optimal procedure fluoroscopic angles and catheter trajectory. Postprocedure CT and MRI are useful in detection of complications such as paravalvular leak, pseudoaneurysm, thrombus, pannus, infective endocardi-tis, and device migration.
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U2 - 10.1148/rg.220153
DO - 10.1148/rg.220153
M3 - Article
C2 - 37384544
AN - SCOPUS:85164231911
SN - 0271-5333
VL - 43
JO - Radiographics
JF - Radiographics
IS - 7
M1 - e220153
ER -