Our Summary

This research paper discusses the growing importance of computed tomography (CT), a type of medical imaging, in heart valve procedures. CT scans provide a 3D view of the heart, making it easier for doctors to assess, plan, and carry out interventions on the aortic and mitral valves of the heart. The use of CT scans helps doctors to choose the right devices, predict the best angles for surgery, and check the success of the procedure after it’s done. The paper focuses on the use of CT scans in two specific procedures: transcatheter aortic valve repair (TAVR) and transcatheter mitral valve replacement (TMVR).

FAQs

  1. What is the role of computed tomography (CT) scans in heart valve procedures?
  2. How do CT scans assist doctors in carrying out transcatheter aortic valve repair (TAVR) and transcatheter mitral valve replacement (TMVR)?
  3. How can CT scans help in predicting the best angles for heart surgery and in checking the success of the procedure?

Doctor’s Tip

One helpful tip a doctor might give a patient undergoing aortic valve replacement is to follow a healthy lifestyle post-surgery to ensure the success of the procedure. This includes maintaining a balanced diet, staying physically active, quitting smoking, and managing stress. These lifestyle changes can help improve overall heart health and reduce the risk of complications after the surgery. Additionally, it is important to attend all follow-up appointments with your healthcare provider to monitor your progress and address any concerns.

Suitable For

Patients who are typically recommended for aortic valve replacement include those with severe aortic stenosis, a condition where the aortic valve becomes narrowed and restricts blood flow from the heart to the rest of the body. Symptoms of severe aortic stenosis include chest pain, shortness of breath, fatigue, dizziness, and fainting. Patients with severe aortic regurgitation, where the aortic valve does not close properly and allows blood to leak back into the heart, may also be recommended for aortic valve replacement.

In some cases, patients with aortic valve disease may not be suitable candidates for traditional open-heart surgery due to factors such as advanced age, underlying health conditions, or previous heart surgeries. For these patients, transcatheter aortic valve replacement (TAVR) may be a minimally invasive alternative. TAVR involves inserting a replacement valve through a catheter in the groin or chest and guiding it to the heart, where it is expanded and positioned within the existing valve.

Similarly, patients with severe mitral valve disease, such as mitral stenosis or regurgitation, may be recommended for mitral valve replacement. Transcatheter mitral valve replacement (TMVR) is a newer procedure that offers a less invasive option for patients who are not candidates for traditional open-heart surgery. TMVR involves inserting a replacement valve through a catheter and positioning it within the diseased mitral valve.

Overall, patients who are experiencing symptoms of severe aortic or mitral valve disease, who have been diagnosed with severe valve dysfunction through imaging tests such as echocardiography, and who are deemed suitable candidates for valve replacement by their healthcare team may be recommended for aortic or mitral valve replacement procedures. The use of CT imaging plays a crucial role in assessing and planning these interventions, ultimately improving outcomes for patients with heart valve disease.

Timeline

  • Before aortic valve replacement:
  1. Patient experiences symptoms of aortic valve disease such as chest pain, shortness of breath, fatigue, and dizziness.
  2. Patient undergoes diagnostic tests such as echocardiogram, cardiac catheterization, and CT scan to determine the severity of the valve disease.
  3. After consulting with a cardiologist and cardiac surgeon, a decision is made to proceed with aortic valve replacement.
  4. Pre-operative preparation including blood tests, imaging studies, and medication adjustments are done.
  • Aortic valve replacement procedure:
  1. Patient is admitted to the hospital and undergoes general anesthesia.
  2. Surgeon performs the aortic valve replacement procedure, which can be done through open-heart surgery or minimally invasive techniques such as TAVR.
  3. A new artificial valve is implanted to replace the diseased valve.
  4. Patient is monitored in the cardiac intensive care unit post-surgery.
  • After aortic valve replacement:
  1. Patient is monitored closely for any complications such as bleeding, infection, or abnormal heart rhythms.
  2. Physical therapy and cardiac rehabilitation may be recommended to help with recovery.
  3. Patient is discharged from the hospital and continues follow-up appointments with the cardiologist.
  4. Patient gradually resumes normal activities and experiences improved symptoms such as increased exercise tolerance and reduced chest pain.

Overall, aortic valve replacement is a complex procedure that requires careful evaluation, preparation, and post-operative care to ensure successful outcomes for the patient.

What to Ask Your Doctor

  1. What are the risks and benefits of undergoing an aortic valve replacement procedure?
  2. What is the recovery process like after aortic valve replacement surgery?
  3. How long can I expect the new valve to last?
  4. Are there any lifestyle changes or medications I will need to take after the procedure?
  5. Will I need to undergo any follow-up tests or imaging scans to monitor the success of the procedure?
  6. Are there any alternative treatments or procedures available for aortic valve replacement?
  7. How experienced is the medical team in performing aortic valve replacement procedures?
  8. What are the potential complications associated with aortic valve replacement surgery?
  9. How long will I need to stay in the hospital after the procedure?
  10. What are the expected outcomes of the aortic valve replacement procedure in terms of improving my heart health and quality of life?

Reference

Authors: Wilson R, McNabney C, Weir-McCall JR, Sellers S, Blanke P, Leipsic JA. Journal: Radiol Clin North Am. 2019 Jan;57(1):165-178. doi: 10.1016/j.rcl.2018.08.001. Epub 2018 Oct 31. PMID: 30454811