Imaging Guidance for Transcatheter Aortic Valve Replacement: Is Transoesophageal Echocardiography the Gold Standard?

Bo Xu, Philip M. Mottram, Siobhan Lockwood, Ian T. Meredith

Research output: Contribution to journalReview ArticleResearchpeer-review

5 Citations (Scopus)


Transcatheter aortic valve replacement (TAVR) is traditionally performed under cardiac imaging guidance. In the early TAVR experience, intra-procedural transoesophageal echocardiography (TOE) is recommended to guide device deployment, in the context of general anaesthesia (GA). Intra-procedural TOE imaging is particularly useful during TAVR deployment as a contrast-saving strategy for patients with renal impairment. Evidence has emerged recently demonstrating that in selected patients, transthoracic echocardiography (TTE) can be used to provide intra-procedural guidance for TAVR. Additionally, there is a growing body of evidence supporting the performance of TAVR using fluoroscopy alone, without additional cardiac imaging. This article aims to provide a contemporary review of the various procedural imaging approaches for TAVR guidance, comparing the relative strengths and weaknesses of each approach (Table 1).

Original languageEnglish
Pages (from-to)1036-1050
Number of pages15
JournalHeart Lung and Circulation
Issue number10
Publication statusPublished - 1 Oct 2017
Externally publishedYes


  • Fluoroscopy
  • Transcatheter aortic valve replacement
  • Transoesophageal echocardiography
  • Transthoracic echocardiography

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