Complementary Role of the Computed Biomodelling through Finite Element Analysis and Computed Tomography for Diagnosis of Transcatheter Heart Valve Thrombosis

Table 1

Preoperative CT scan methods of severe aortic valve stenosis acquisition data before TAVR.

Procedure	Acquisition		Stratification data
CT scan 250 Multislice	DPL		AORTIC VALVE ANALYSIS
Leaflet and aortic root features; and behavior	459 mGy/cm	Functional aortic structure assessment	Morphological aortic valve study	Anatomical AVA determination
Aorta CTA and TAVI planning	(i) Fast acquisition (<7 sec) with uniform contrast.; (ii) Ensure excellent IQ on coronaries, aortic valves & ascending aorta even without Betablocker	Mixed axial gated & helical ungated modes	Lower dose: up to 70% dose reduction	MMAR to reduce metal artifact when hip prosthesis
2D Echocardiography
Aortic valve leaflet	Parasternal short-axis	>20 mm	96%	97%
Aortic valve area	Parasternal long-axis	≥2.5 cm^2	64%	95%
Aortic Gradient	Parasternal long-axis	≥39.5°	98%	97%
ITVI	Parasternal long-axis	≥45°	100%	95%
Left ventricular end-diastolic diameter	Parasternal long-axis	>65 mm	Not available	Not available
Left ventricular end-systolic volume	Apical 4-chamber	≥145 mL	90%	90%
FE Teichholz	Parasternal long-axis	≥2.5 cm^2	64%	95%
Pisa radius	Apical 4-chamber	≥10 mm	64%	90%
Mitral Gradient	Parasternal long-axis	≥11 mm	81%	84%
Basal aneurysm/dyskinesis	Apical, parasternal, or short-axis	Present	Not available	Not available
3D Echocardiography
Aortic leaflet	Full volume modeling	≥29.9°	85%	89%
Aortic area	Full volume modeling	≥29.9° + yes	85%	92%