Table 1.
Suggested assessment steps for TMVR with preferred modalities.
| Assessment Steps | TEE | CT |
|---|---|---|
| Screening | ||
| Valve disease mechanism | +++ | + |
| Chambers size | +++ | ++ |
| LV/RV function and pulmonary hypertension | +++ | + |
| Valve disease grading | +++ | - |
| Calcification extension | + | +++ |
| Contra-indications assessment | ||
| Endocarditis | +++ | + |
| Thrombus | +++ | +++ |
| Severe patient-prosthesis mismatch | +++ | - |
| Peri-intervention | ||
| Vascular access | - | +++ |
| Annulus sizing | ++ | +++ |
| Fusion imaging | ++ | +++ |
| Interatrial septum assessment/transeptal punction planning | +++ | +++ |
| Fluoroscopic projection estimation | - | +++ |
| Neo-LVOT size estimation | + | +++ |
| 3D simulation/printing | + | +++ |
| Procedural guidance/Device deployment | +++ | - |
| Post-procedural | ||
| Prosthetic valve function | +++ | + |
| Paravalvular leak | +++ | ++ |
| Vascular complications | - | +++ |
+++ Preferred method; ++ alternative method; + incomplete assessment; - not possible.