Journal
EUROPEAN RADIOLOGY
Volume 26, Issue 12, Pages 4497-4504Publisher
SPRINGER
DOI: 10.1007/s00330-016-4320-8
Keywords
Heart valve prosthesis implantation; Transcatheter aortic valve implantation (TAVI); Low contrast agent; Computed tomography; Aortography
Funding
- Siemens Healthcare
- Abbott Vascular
- German government [01EX1012B]
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Chronic renal failure is common in patients referred for transcatheter aortic valve implantation (TAVI). CT angiography is recommended and provides crucial information prior to TAVI. We evaluated the feasibility of a reduced contrast volume protocol for pre-procedural CT imaging. Forty consecutive patients were examined with prospectively ECG-triggered high-pitch spiral acquisition using a novel third-generation dual-source CT system; 38 ml contrast agent was used. Image quality was graded on a visual scale (1-4). Contrast attenuation was measured at the level of the aortic root and at the iliac bifurcation. Mean patient age was 82 +/- 6 years (23 males; 58 %). Mean attenuation/average image quality was 285 +/- 60 HU/1.5 at the aortic annulus compared to 289 +/- 74 HU/1.8 at the iliac bifurcation (p = 0.77/p = 0.29). Mean estimated effective radiation dose was 2.9 +/- 0.3 mSv. A repeat acquisition was necessary in one patient due to image quality. Out of the 35 patients who underwent TAVI, 31 (89 %) patients had no or mild aortic regurgitation. Thirty-two (91 %) patients were discharged successfully. Pre-procedural CTA with a total of 38 ml contrast volume is feasible and clinically useful, using third-generation dual-source CT, allowing comprehensive imaging for procedural success. aEuro cent Reduction of contrast agent volume is crucial in patients with chronic renal failure. aEuro cent Novel third-generation computed tomography helps to reduce contrast agent volume. aEuro cent Pre-procedural CT allows comprehensive imaging for procedural success before heart valve implantation. aEuro cent A low-contrast CT protocol is feasible for pre-procedural TAVI planning.
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