**2. Selection of patient**

Due to the existence of tried and tested surgical AVR with good long-term results, the selec‐ tion of patients for transcatheter aortic valve implantation (TAVI), which should done in a multidisciplinary consultation between cardiologists, surgeons, imaging specialists, and an‐ esthesiologists, involves several critical steps [6]. Candidates considered for TAVI must have severe symptomatic AS in addition to a formal contraindication to surgery or other charac‐ teristics that would limit their surgical candidacy because of excessive mortality or morbidi‐

© 2013 Akin et al.; licensee InTech. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. © 2013 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

ty (Figure 2). The procedure should be offered to patients who have a potential for functional improvement after valve replacement. It is not recommended for patients who simply refuse surgery on the basis of personal preference.

the severity of AS should be assessed. Both transthoracic (TTE) and transesophageal (TEE)

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In addition, the exact anatomy of the aortic valve should be assessed. Echocardiography, multislice CT (MSCT), and magnetic resonance imaging (MRI) can all help to distinguish be‐ tween a bicuspid and a tricuspid aortic valve. It is important to point out that implantation of available percutaneous prostheses is contraindicated in the case of a bicuspid aortic valve, because of the risk of incomplete deployment, significant paravalvular regurgitation, and

**Figure 3.** ECG-gated CT-scan in a patient with severe aortic valve stenosis (the upper right panel shows the isolated

Doppler echocardiography are the preferred tools (Figure 2).

**Figure 2.** TTE in the assessment of severe AS

calcification of the tricuspid aortic valve)

displacement of the prosthesis [6,7] (Figure 3).

**Figure 1.** Algorithm to determine the treatment options of patients with severe AS (AVA: aortic valve area; TAVI: transcatheter aortic valve implantation)
