Die Transkatheter Aortenklappenimplantation Screening, Diagnostik und Klappenauswahi

摘要

Transcatheter aortic valve implantation (TAVI) has emerged as the preferred procedure for the treatment of patients with severe aortic stenosis at high operative risk. Despite major advances of the past years with improving procedural results, careful screening and evaluation remains pivotal for an optimized therapeutic strategy. In the event of severe symptomatic aortic stenosis, as first step the individual peri-procedural risk should be determined, considering various risk-scores and comorbidities. Once the indication for TAVI has been confirmed, the key diagnostic modality to assess the feasibility of TAVi is multislice computed tomography of the aortic root, the complete aorta and femoral arteries. It provides information necessary to choose the appropriate access site as well as type and size of the prosthesis. This sophisticated imaging takes into account the increasing diversity of available transcatheter.heart valves and allows for a customized differential therapy.