Advanced CT-based imaging techniques to evaluate coronary access following TAVI for degenerated surgical bioprosthesis

Coronary access after transcatheter aortic valve implantation (TAVI) can be challenging. We describe the use of advanced computed tomography (CT)–based imaging techniques to evaluate, plan, and simulate coronary access after TAVI for a degenerated surgical bioprosthesis. Postprocedural (pp) CT data were segmented to create a 3D digital model, which was visualised with the use of mixed reality technology to enable operators to virtually plan a cannulation strategy. Bench testing was then performed in a patient-specific 3D printed model to determine the optimal coronary cannulation technique. Our case demonstrates how advanced CT-based imaging techniques can be used to improve preprocedural planning of structural heart interventions.