作者：Paul Schoenhagen1, J?rg Hausleiter2, Stephan Achenbach3, Milind Y. Desai1, E. Murat Tuzcu1
单位：1Cleveland Clinic, Imaging Institute and Heart & Vascular Institute, Cleveland, USA; 2Deutsches Herzzentrum München, Department of Cardiology, Munich, Germany; 3University of Erlangen, Department of Cardiology, Erlangen, Germany
通讯作者: Paul Schoenhagen, MD.
联系方式：Cardiovascular Imaging, Cleveland Clinic, 9500 Euclid Ave, Desk J 1-4, Cleveland, OH 44195. Tel: 216-445-7579. E-mail: schoenp1@ccf.org.
摘要：如果不及时治疗，有症状的严重主动脉狭窄（AS）的预后很差。通过心脏瓣膜置换手术可以达到良好的短期和长期治疗效果。但是，很多患有多重疾病、以及有着较高手术风险的老年患者却无法接受这种手术治疗。对这些特殊患者来说，经导管主动脉瓣置入术（TAVI）成为一个不错的选择。这种手术的特点是：无暴露和可视化的手术视野，并且在选择患者、手术准备以及手术过程本身，都依赖计算机扫描图像（CT）的引导。本文将介绍多排计算机断层扫描（MDCT）在TAVI手术过程中如何对主动脉瓣，主动脉根部以及髂动脉进行全面定位。
关键词：主动脉瓣狭窄；经导管主动脉瓣置入术；成像技术；计算机断层扫描
英文原文：
Computed Tomography in the Evaluation for Transcatheter Aortic Valve Implantation (TAVI)
Paul Schoenhagen1, J?rg Hausleiter2, Stephan Achenbach3, Milind Y. Desai1, E. Murat Tuzcu1
1Cleveland Clinic, Imaging Institute and Heart & Vascular Institute, Cleveland, USA; 2Deutsches Herzzentrum München, Department of Cardiology, Munich, Germany; 3University of Erlangen, Department of Cardiology, Erlangen, Germany
Corresponding to: Paul Schoenhagen, MD. Cardiovascular Imaging, Cleveland Clinic, 9500 Euclid Ave, Desk J 1-4, Cleveland, OH 44195. Tel: 216-445-7579. E-mail: schoenp1@ccf.org.
Abstract：If left untreated, symptomatic, severe aortic stenosis (AS) is associated with a dismal prognosis. Open-heart surgical valve replacement is the treatment of choice and is associated with excellent short and long-term outcome. However, many older patients with multiple co-morbidities and anticipated increased surgical risk are excluded from surgical intervention. For these patients, transcatheter aortic valve implantation (TAVI) is emerging as a viable treatment alternative. Transcatheter valvular heart procedures are characterized by lack of exposure and visualization of the operative field, therefore relying on image guidance, both for patient selection and preparation and the implantation procedure itself. This article describes the role of multi-detector row computed tomography (MDCT) for detailed assessment of the aortic valve, aortic root, and iliac arteries in the context of TAVI.
