Cardiac CT Before Valve and TAVI Procedures

Cardiac CT is used before transcatheter aortic valve implantation (TAVI) to measure the aortic valve, the heart and the blood vessels used to reach it. It helps the heart team choose the valve size and route safely. It is also used before some other structural heart procedures.

What Is Aortic Stenosis and TAVI?

Aortic stenosis is narrowing of the heart valve, often due to calcium with ageing. It causes breathlessness, chest pain and fainting. TAVI replaces the valve through a catheter, usually from the leg artery, without opening the chest. It is used in many people who are at high or intermediate risk for open surgery. See heart attack warning signs for symptoms to watch.

MeasurementWhy it mattersAortic annulus sizeChoosing the correct valve sizeCalcium amount and positionRisk of leak or blockageHeight of coronary openingsRisk of blocking the arteriesFemoral and iliac artery size and calciumWhether the leg route is possibleHeart arteriesWhether a blockage also needs treatment

What Does the Planning CT Include?

• An ECG-gated scan of the heart and aortic root
• A CT angiography from the chest to the groin to assess access vessels
• Sometimes a coronary CT to check heart arteries

Scans use iodine contrast and take seconds. See how CTCA works.

Kidney and Rhythm Considerations

Many TAVI patients are older and have kidney disease, so contrast dose is minimised and kidney function is checked. Atrial fibrillation or a fast heart rate can degrade images, and the team may use special protocols or a low-contrast technique. See CTCA and kidney function.

Preparation

Fast for 4 to 6 hours, carry a recent creatinine report, echo and angiography reports and a medicine list. Tell the staff about diabetes, allergy and pacemakers. See CTCA preparation.

A Practical Example

Mohinder, 80, has severe aortic stenosis and breathlessness on walking. A cardiac CT shows a moderately calcified valve, suitable access arteries and adequate distance for the coronary openings. His heart team chooses a self-expanding valve through the right femoral artery, and he walks the next day. The planning scan helped avoid complications.

Understanding Your Report

The report lists valve size, calcium score of the valve, coronary heights, vessel diameters and any other findings such as coronary disease or incidental lung changes. Your heart team will use these numbers for sizing and approach, and may repeat measurements.

After the Scan and Next Steps

Take the report to your cardiologist and the heart team at a TAVI centre. The decision between TAVI and open surgery depends on age, risk, anatomy and your preferences. After a valve procedure, you will need antiplatelet or anticoagulant medicines, regular echo checks and dental care to prevent infection of the new valve.

Questions to Ask Your Doctor

• Am I suitable for TAVI or surgery?
• Which valve size and route are best for me?
• Is my kidney function safe for contrast?
• Do I also need treatment for heart artery blockages?

Common Mistakes to Avoid

• Ignoring breathlessness or fainting in aortic stenosis.
• Skipping the creatinine report.
• Stopping blood thinners after the procedure without advice.

Booking, Timing and Report

Book a morning slot if possible, since fasting is easier. Carry your doctor's prescription, previous heart and blood reports, a recent creatinine report and a medicine list. Allow 45 to 90 minutes at the centre. Reports are usually ready within 24 to 48 hours, because vessel images need careful review.

Care Tips and Key Facts

• Report breathlessness, chest pain or fainting early
• Keep dental hygiene to protect the new valve
• Take blood thinners exactly as prescribed
• Keep follow-up echo dates

Who Decides and How Long It Takes

The heart team (cardiologist, cardiac surgeon, imaging specialist and anaesthetist) reviews your scan, echo and general health, and discusses the options with you and your family. Planning usually takes a few days to weeks, depending on how urgent your symptoms are.

Frequently Asked Questions

What is TAVI?

Replacing the aortic valve using a catheter.

Why is CT needed before TAVI?

To measure the valve and vessels.

Is the CT scan safe for kidneys?

Contrast is limited and kidney function is checked.

Do I need fasting?

Yes, 4 to 6 hours.

Can echo replace CT?

No; CT gives key measurements.

Can CT show heart blockages too?

Yes, in selected patients.

Is TAVI suitable for everyone?

No; the heart team decides.

How long does the scan take?

Seconds; the visit about an hour.

When is the report ready?

Usually 24 to 48 hours.

Book Your Test at Ganesh Diagnostic

Ganesh Diagnostic & Imaging Centre in Rohini, Delhi offers this test with trained radiology staff and clear reports. You can book an appointment online, check our branches across Delhi NCR, contact us for current rates, or explore all our services. Reports can be downloaded online through our patient portal, so you do not need to make a second trip just to collect them.

This article is for general information only. It does not replace advice from your doctor. Always follow your doctor's instructions for your test.

Related Reading

• CT Renal Angiography for Kidney Artery Disease
• FFR-CT Explained: Blood Flow From CT Angiography
• CT Angiography Brain for Aneurysm and Bleeding
• CT Coronary Angiography Before Non-Cardiac Surgery
• CT Angiography of Neck (Carotid) Arteries
• High Cholesterol: When to Get a Heart Scan
• When Not to Do CT Coronary Angiography
• CT Coronary Angiography for Chest Pain