Basics / Search Pattern

TAVR Study

  • Read like normal CT chest with special additions

  • Items to specially evaluate

    • Aortic valve for calcifications

    • Looks at origin of coronary arteries and the distance of the RCA & Left main from the aortic valve so that when prosthetic valve is placed it does overlap on the coronary artery origin and occlude them

    • Femoral and iliac arteries to evaluate the arterial access site for the actual procedure

    • LV outflow tract angle

    • Aortic valve diameter

  • Steps

    • Read everything but the heart like normal

    • Read coronary calcium score like normal

    • Now the TAVR specific

    • Right click the first raw data picture (static looking image)

    • Click philips applications —> cardiac CT viewer —> click open when new tab opens

  • Will need to manipulate image so that the following screen shots can be obtained

  • MAKE SURE TO TAKE SCREENSHOTS OR YOU WILL HAVE TO REDO EVERYTHING

  • Bottom right corner —> camera drop down —> film screen snapshot

  • Then floppy disc save drop down —> save screen snapshot as —> new menu will open asking where to save —> PACS should be auto-selected but ensure that is what is selected and then click save

  • RCA + Aortic valve in same plane with measurement included (left image)

  • Left main + Aortic valve in same plane with measurement included (right image)

  • Circumference of the aortic valve can be measured

    • Use spline tool (bottom right corner —> circle tool dropdown menu —>spline contour

  • LV outflow tract with proximal aorta

    • Click the angle measurement in the bottom left and draw line from apex of LV to aortic valve, then second portion extending from valve along the plane of the ascending aorta

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