CT imaging prior to transcatheter aortic valve implantation in the UK

Iwan Harries (Lead / Corresponding author), Jonathan R. Weir-Mccall, Michelle C. Williams, James Shambrook, Giles Roditi, Russel Bull, Gareth J. Morgan-Hughes, Edward D. Nicol, Alastair J. Moss

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Abstract

Objective: This cross-sectional observational study sought to describe variations in CT in the context of transcatheter aortic valve implantation (CT-TAVI) as currently performed in the UK.

Methods: 408 members of the British Society of Cardiovascular Imaging were invited to complete a 27-item online CT-TAVI survey.

Results: 47 responses (12% response rate) were received from 40 cardiac centres, 23 (58%) of which performed TAVI on-site (TAVI centres). Only six respondents (13%) performed high-volume activity (>200 scans per year) compared with 13 (28%) performing moderate (100-200 scans per year) and 27 (59%) performing low (0-99 scans per year) volume activity. Acquisition protocols varied (41% retrospective, 12% prospective with wide padding, 47% prospective with narrow padding), as did the phase of reporting (45% systolic, 37% diastolic, 11% both, 6% unreported). Median dose length product was 675 mGy.cm (IQR 477-954 mGy.cm). Compared with non-TAVI centres, TAVI centres were more likely to report minimum iliofemoral luminal diameter (n=25, 96% vs n=7, 58%, p=0.003) and optimal tube angulation for intervention (n=12, 46% vs n=1, 8%, p=0.02).

Conclusions: This national survey formally describes current CT-TAVI practice in the UK. High-volume activity was only present at one in seven cardiac CT centres. There is wide variation in scan acquisition, scan reporting and radiation dose exposure in cardiac CT centres.

Original languageEnglish
Article numbere001233
Pages (from-to)1-7
Number of pages7
JournalOpen Heart
Volume7
Issue number1
Early online date6 Apr 2020
DOIs
Publication statusPublished - 6 Apr 2020

Keywords

  • aortic valve disease
  • CT scanning
  • percutaneous valve therapy

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    Harries, I., Weir-Mccall, J. R., Williams, M. C., Shambrook, J., Roditi, G., Bull, R., Morgan-Hughes, G. J., Nicol, E. D., & Moss, A. J. (2020). CT imaging prior to transcatheter aortic valve implantation in the UK. Open Heart, 7(1), 1-7. [e001233]. https://doi.org/10.1136/openhrt-2019-001233