Since its introduction in 2022, transcatheter aortic valve implantation (TAVI) has revolutionized the treatment and prognosis of patients with aortic stenosis. Robust clinical trial data and a wealth of scientific evidence support its efficacy and safety. One of the key factors for success of the TAVI procedure is careful preprocedural planning using imaging. Computed tomography (CT) has developed into the standard imaging method for comprehensive patient assessment in this context. Suitability of the femoral and iliac arteries for transfemoral access, exact measurement of aortic annulus size and geometry as the basis for prosthesis selection, quantification of the spatial relationship of the coronary ostia to the aortic annular plane, and identification of optimal fluoroscopic projection angles for the implantation procedure are among the most important information that can be gained from preprocedural CT. Further research is aimed at improving risk stratification, for example, with respect to annular perforation, periprosthetic aortic regurgitation, and need for postprocedural implantation of a permanent pacemaker.

自 2022 年推出以来，经导管主动脉瓣植入术 (TAVI) 彻底改变了主动脉瓣狭窄患者的治疗和预后。可靠的临床试验数据和丰富的科学证据支持其有效性和安全性。TAVI 手术成功的关键因素之一是使用影像进行仔细的术前规划。在此背景下，计算机断层扫描 (CT) 已发展成为用于全面患者评估的标准成像方法。股动脉和髂动脉是否适合经股动脉入路，精确测量主动脉环尺寸和几何形状作为假体选择的基础，量化冠状动脉口与主动脉环平面的空间关系，以及确定最佳透视投影角度植入过程是可从术前 CT 获得的最重要信息之一。进一步的研究旨在改善风险分层，例如环形穿孔、假体周围主动脉瓣反流以及术后植入永久起搏器的需要。