When to consider cardiovascular magnetic resonance in patients undergoing transcatheter aortic valve replacement?

Abstract

Purpose of review 

To discuss the relevant techniques as well as the recent evidence that enhance the understanding of the reader on the applications of cardiovascular magnetic resonance (CMR) in transcatheter aortic valve replacement (TAVR). With different cardiac imaging modalities available as well as the advent of TAVR, it is important to define when CMR can be helpful in the periprocedural evaluation.

Recent findings 

The topics of interest covered in this review are CMR evaluation of aortic stenosis/regurgitation, TAVR sizing, vascular measurements for access planning, postimplantation paravalvular regurgitation (PVR), and the potential role of delayed enhancement assessment in patients undergoing TAVR.

Summary 

CMR is a complementary modality in the assessment of TAVR candidates. The ability of CMR to assess the hemodynamic significance of aortic stenosis and other valvulopathies, as well as to assess accurately the left ventricular ejection fraction and vascular anatomy, makes this technique well rounded. The roles of delayed enhancement for myocardial scar in the evaluation of TAVR candidates and PVR assessment in the postimplant patient are promising, but still yet to be fully defined.