The use of imaging in pre-TAVI assessment: a review

Transcatheter aortic valve implantation (TAVI) has risen as a non-invasive alternative for treatment of severe symptomatic aortic stenosis in patients with high surgical risk. Multimodality imaging approach and a complementary evaluation including the clinical judgment of the heart team are mandatory. Echocardiography serves as a first-line test for the evaluation of aortic valve stenosis degree and computed tomography (CT) has a pivotal role in pre-interventional evaluation of both the aortic root anatomy and aorto-iliofemoral vessels as a single examination. Cardiac magnetic resonance is useful in grading the severity of aortic stenosis and should be considered a reasonable alternative to CT for the evaluation of the aortic annulus when the administration of contrast media is contraindicated.

This review narrative analyzes the current scientific literature and the development of the TAVI in patients with aortic stenosis, describing the increasingly important role of imaging techniques and their pre-procedural contribution.