Abstract
Computed tomography image analysis for transcatheter aortic valve replacement requires a comprehensive analysis of aortic root anatomy. There is no absolute threshold for any measurement that can determine treatment choice. Rather, image interpretation is a qualitative exercise, and decisions are based on accumulated experience from computed tomography anatomical review and treatment outcomes that help to refine future case selection. This review addresses potentially challenging scenarios for transcatheter aortic valve replacement and describes the imaging findings that should be considered in deciding a treatment approach. Common challenges are discussed with images to illustrate typical findings.