Cardiovascular magnetic resonance facilitates entirely contrast-free transcatheter aortic valve implantation: case report. Issue 12 (28th September 2021)

• Record Type: Journal Article
• Authors: Raby, Jonathan; Newton, James D; Dawkins, Sam; Lewis, Andrew J M
• Editors: Hatipoglu, Suzan; Filomena, Domenico; De Carvalho, Filipe Penna; Mukherjee, Rahul; Mehta, Vishal Shahil
• Is Part Of: European heart journal. Volume 5:Issue 12(2021)
• Publication Date: 2021-09-28
• Subjects: Case report -- Magnetic resonance imaging -- Aortic valve -- Imaging -- Intervention; Cardiology -- Periodicals; Cardiology -- Case studies -- Periodicals; Heart -- Diseases -- Periodicals; Heart -- Diseases -- Case studies -- Periodicals; 616.12
• DOI: 10.1093/ehjcr/ytab378
• Languages: English
• ISSNs: 2514-2119

Abstract

Abstract: Background: Transcatheter aortic valve implantation (TAVI) is usually planned using contrast-enhanced computed tomography (CT) to determine the suitability of cardiovascular anatomy. Computed tomography for TAVI planning requires the administration of intravenous contrast, which may not be desirable in patients with severely reduced renal function. Case summary: We present an unusual case of an 89-year-old patient with an urgent need for treatment of critical, symptomatic aortic stenosis who also had severe chronic kidney disease. We judged that this posed a relative contraindication to the use of intravenous contrast. We designed and implemented a novel, contrast-free cardiovascular magnetic resonance (CMR) protocol and used this to plan all aspects of the procedure. Transcatheter aortic valve implantation was conducted successfully with zero contrast medium administration leading to an excellent clinical result and recovery of renal function. Conclusion: Contrast-free CMR appears to be a viable alternative to CT for planning structural aortic valve intervention in the rare cases where intravenous contrast is relatively contraindicated.