Papel de las técnicas de imagen en el TAVI. ¿La técnica utilizada influye en los resultados?

Imaging techniques are of fundamental importance for achieving superior outcomes in transcatheter aortic valve implantation (TAVI). Transthoracic echocardiography can be used to diagnose the severity of aortic stenosis, to identify the presence of associated valvular disease, to assess left ventricular morphology and function, and to determine the aortic annulus diameter. Computed tomography provides better estimates of the size of the aortic annulus (particularly when it has an oval morphology), the extent of aortic valve calcification, the distance between the coronary arteries and the aortic annulus, and the most appropriate route for prosthesis implantation. The procedure itself can be accurately monitored using either transesophageal echocardiography, fluoroscopy or angiography. Transesophageal echocardiography, particularly with 3-dimensional imaging, is able not only to confirm the size of the aortic annulus, but is also vital for verifying the correct positioning of the prosthesis, for assessing the degree of residual regurgitation and for ruling out possible intraprocedural complications.