Purpose: The use of low contrast CTA for TAVR is desirable in patients with renal dysfunction but is not yet well established. This systematic review and meta-analysis compares low contrast computed tomography angiography (CTA) versus conventional CTA in patients with aortic stenosis undergoing transcatheter aortic valve replacement (TAVR) planning.
Methods: We performed a systematic literature review to identify clinical studies comparing imaging strategies for patients with aortic stenosis undergoing TAVR planning. The primary outcomes of image quality as assessed by the signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were reported as random effects mean difference with 95% confidence interval. No prior ethical approval was required since all data is public.
Results: Our search yielded 126 potential studies. We included 6 studies reporting on 353 patients. There was no difference in SNR between the low-dose and conventional protocols with a mean difference of -1.42 (95% CI -5.71-2.88, p = 0.52). There was no difference in CNR between the low-dose and conventional protocols with a mean difference of -3.83 (95% CI -9.98-2.32, p = 0.22).
Conclusion: This systematic review and meta-analysis suggests that low contrast CTA for TAVR planning provides similar image quality to conventional CTA.