ACR Appropriateness Criteria((R)) Imaging for Transcatheter Aortic Valve Replacement

UMMS Affiliation

Department of Radiology

Publication Date


Document Type



Cardiovascular Diseases | Cardiovascular System | Radiology | Surgery


Aortic stenosis is a common valvular condition with increasing prevalence in aging populations. When severe and symptomatic, the downstream prognosis is poor without surgical or transcatheter aortic valve replacement. Transcatheter aortic valve replacement is now considered a viable alternative to surgical aortic valve replacement in patients considered high and intermediate risk for surgery. Pre-intervention imaging with echocardiography and CT are essential for procedure planning and device selection to help optimize clinical outcomes with MR angiography playing largely a complementary role. Modern 3-D cross-sectional imaging has consistently shown to help reduce procedural complications from vascular access injury to paravalvular regurgitation and coronary obstruction. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.


AUC, Aortic stenosis, Appropriateness Criteria, Appropriateness Use Criteria, Coronary obstruction, Paravalvular regurgitation, TAVR, Transcatheter heart valve

DOI of Published Version



J Am Coll Radiol. 2017 Nov;14(11S):S449-S455. doi: 10.1016/j.jacr.2017.08.046. Link to article on publisher's site

Journal/Book/Conference Title

Journal of the American College of Radiology : JACR


Full author list omitted for brevity. For the full list of authors, see article.

Related Resources

Link to Article in PubMed

PubMed ID