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Gated CTA TMVR

Last Updated: 2026-01-01 Author:

  • 1. Clinical Summary

    Series Phase Coverage
    Calcium Score Non-Contrast Carina to Base of heart
    Gated CTA Chest Arterial (bolus tracked) Carina to Base of heart
    Delayed CAP Contrast (80 sec delay from CTA) Diaphragm to Femoral heads
    • Pre-TMVR planning
    • Mitral valve replacement planning
    • Mitral regurgitation

  • 2. Patient Prep

    • Position: Supine with arms raised
    • NPO Status: NPO 4 hours
    • Pre-Medication:
      • HR < 65 target. Premedication not required.

  • 3. IV Contrast & Injection

    Parameter Value
    Agent IsoVue 370
    Volume 1.1 mL/kg
    Flow Rate 5 mL/s
    Duration 15s
    Timing Method Bolus Tracking
    ROI Placement Ascending aorta
    Trigger (HU) 180 HU

    Use full dose if GFR > 30

    If GFR < 30

    Max Contrast = \(2*\left[\frac{\text{Patient Weight}}{75 \text{ kg}} * \text{eGFR}\right]\)

  • 4. Special Notes

    • Gated CHEST with NO DOSE PULSING (full dose all phases) + delayed 80 sec CAP. TMVR post-processing required
    • Additional Recons: TMVR measurements: annulus dimensions. LVOT area. Coronary heights. LA volume. Access vessels
    • 20G IV

    Safety First

    • Renal Function: Verify eGFR > 30
    • Allergy: Check allergy history
    • Measure mitral annulus. LA size. LVOT assessment. Coronary proximity. Access vessels. TMVR-specific measurements
    • NO dose modulation for gated chest. Full radiation all phases for valve assessment
Series Name Start Location End Location Delay Slice Thickness Notes
Scout Thoracic inlet Femoral heads N/A N/A AP lateral
Calcium Score Carina Base of heart N/A 2.5 mm Calcium scoring
Gated CTA Chest Carina Base of heart Bolus tracked 0.5 mm NO DOSE PULSING - retrospective all phases
Delayed CAP Diaphragm Femoral heads 80 sec 0.625 mm Access planning and coronaries
Plane Acquisition FOV Thickness/Increment Kernel IR Strength Notes
Axial Calcium Score Apex of heart to Base of heart 2.5 mm/2.5 mm Cardiac 3 Calcium scoring
Axial Gated chest Heart 0.5 mm/0.5 mm Cardiac 3 Mitral valve measurements
Axial Delayed CAP AP 2 mm/2 mm Vascular 3 Access vessels
Double oblique Gated chest Mitral valve 0.5 mm Cardiac 3 En face mitral annulus
3D VR Delayed CAP Iliofemoral 1.5 mm Vascular 3 Access planning