Calcification of the aortic valve and mitral apparatus: location, quantification and implications for device selection

The treatment of both aortic and now mitral valvular disease has been transformed through transcatheter valvular interventions. TAVR has rapidly become the treatment of choice for symptomatic severe aortic stenosis in both high, and now intermediate-risk patients. Building upon this success the last two years have seen the clinical introduction of transcatheter mitral valve replacement (TMVR), with a number of devices being utilised in first-in-man and feasibility studies. These experiences have helped determine the anatomical requirements and specifications that enable successful device deployment and avoidance of complications. A unique strength of cardiac CT is the ability to identify and characterise calcification of the aortic and mitral apparatus, en-abling a deeper understanding of the relationship of calcification and procedural complications.