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Onishi T, Tang GHL. Management of difficult coronary anatomy during transcatheter aortic valve implantation: what are the key issues? Curr Opin Cardiol 2025:00001573-990000000-00212. [PMID: 40305236 DOI: 10.1097/hco.0000000000001229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/02/2025]
Abstract
PURPOSE OF REVIEW Predicting and preventing coronary obstruction in transcatheter aortic valve replacement (TAVR) is crucial due to its high mortality risk. RECENT FINDINGS In native TAVR, predicting coronary obstruction requires assessing aortic cusp height, coronary artery height, valve-to-coronary distance, and leaflet calcium volume. The VIVID classification has been proposed for evaluating the risk of coronary obstruction in TAVR for failed bioprosthetic surgical valves. After TAVR with the Sapien 3 valve, the feasibility of redo TAVR and coronary access decreases with a shallower implantation of the initial Sapien 3. In redo TAVR of Sapien 3 within an Evolut valve, positioning the Sapien 3 outflow at node 4 improves redo TAVR feasibility and coronary accessibility compared to positioning at nodes 5 or 6. For valve sizing in redo TAVR with Sapien 3, in-vivo CT sizing results in smaller valve sizes than bench sizing, reducing coronary risk and improving redo TAVR feasibility. Leaflet modification and coronary stenting techniques and a dedicated leaflet-splitting device have been proposed to maintain coronary perfusion in high-risk cases. SUMMARY Coronary preservation in high-risk TAVR remains a significant challenge, requiring further research into preprocedural planning and leaflet modification strategies.
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Affiliation(s)
- Takayuki Onishi
- Mount Sinai Fuster Heart Hospital, Icahn School of Medicine at Mount Sinai
| | - Gilbert H L Tang
- Mount Sinai Fuster Heart Hospital, Icahn School of Medicine at Mount Sinai
- Department of Cardiovascular Surgery, Mount Sinai Health System, New York, New York, USA
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2
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Sava RI, Garot P, Benamer H, Gall E, Pezel T, Djebbar M, Sayah N, Meier D, Tzimas G, Garot J, Leclercq F, Akodad M. Redo-Transcatheter Aortic Valve Replacement Procedural Optimization and Patient Selection: From Bench to Clinical Practice. J Clin Med 2025; 14:2770. [PMID: 40283600 PMCID: PMC12027932 DOI: 10.3390/jcm14082770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2025] [Revised: 04/10/2025] [Accepted: 04/11/2025] [Indexed: 04/29/2025] Open
Abstract
With recent guidelines expanding transcatheter aortic valve replacement (TAVR) to younger patients, indications for redo-TAVR will also likely increase. When compared with TAVR, redo-TAVR is a rare and novel procedure. Current clinical data derived from registries suggest excellent safety, with low rates of 30-day and 1-year mortality following redo-TAVR. Proper understanding of data from bench studies regarding optimal valve configurations, of patient anatomy and of the technical properties of transcatheter heart valves (THV) is essential for patient selection and procedural success. Lifetime management of redo-TAVR should start before the index procedure, as the choice of the index THV has a major impact on the feasibility of redo-TAVR. Procedural optimization by adequate valve sizing, commissural alignment and adequate implant depth of both index and redo-THV are critical determinants of optimal hemodynamics for maximized valve longevity, as well as lifelong coronary access.
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Affiliation(s)
- Ruxandra I. Sava
- Institut Cardiovasculaire Paris Sud, Hôpital Privé Jacques Cartier, Ramsay Santé, 91300 Massy, France; (R.I.S.); (P.G.); (H.B.); (E.G.); (M.D.); (N.S.); (J.G.)
| | - Philippe Garot
- Institut Cardiovasculaire Paris Sud, Hôpital Privé Jacques Cartier, Ramsay Santé, 91300 Massy, France; (R.I.S.); (P.G.); (H.B.); (E.G.); (M.D.); (N.S.); (J.G.)
| | - Hakim Benamer
- Institut Cardiovasculaire Paris Sud, Hôpital Privé Jacques Cartier, Ramsay Santé, 91300 Massy, France; (R.I.S.); (P.G.); (H.B.); (E.G.); (M.D.); (N.S.); (J.G.)
| | - Emmanuel Gall
- Institut Cardiovasculaire Paris Sud, Hôpital Privé Jacques Cartier, Ramsay Santé, 91300 Massy, France; (R.I.S.); (P.G.); (H.B.); (E.G.); (M.D.); (N.S.); (J.G.)
- Department of Cardiology, University Hospital of Lariboisiere, (Assistance Publique des Hôpitaux de Paris, AP-HP), Université Paris-Cité, 75013 Paris, France;
| | - Théo Pezel
- Department of Cardiology, University Hospital of Lariboisiere, (Assistance Publique des Hôpitaux de Paris, AP-HP), Université Paris-Cité, 75013 Paris, France;
| | - Morad Djebbar
- Institut Cardiovasculaire Paris Sud, Hôpital Privé Jacques Cartier, Ramsay Santé, 91300 Massy, France; (R.I.S.); (P.G.); (H.B.); (E.G.); (M.D.); (N.S.); (J.G.)
| | - Neila Sayah
- Institut Cardiovasculaire Paris Sud, Hôpital Privé Jacques Cartier, Ramsay Santé, 91300 Massy, France; (R.I.S.); (P.G.); (H.B.); (E.G.); (M.D.); (N.S.); (J.G.)
| | - David Meier
- Department of Cardiology, Lausanne University Hospital and University of Lausanne, 1005 Lausanne, Switzerland; (D.M.); (G.T.)
| | - Georgios Tzimas
- Department of Cardiology, Lausanne University Hospital and University of Lausanne, 1005 Lausanne, Switzerland; (D.M.); (G.T.)
| | - Jérôme Garot
- Institut Cardiovasculaire Paris Sud, Hôpital Privé Jacques Cartier, Ramsay Santé, 91300 Massy, France; (R.I.S.); (P.G.); (H.B.); (E.G.); (M.D.); (N.S.); (J.G.)
| | | | - Mariama Akodad
- Institut Cardiovasculaire Paris Sud, Hôpital Privé Jacques Cartier, Ramsay Santé, 91300 Massy, France; (R.I.S.); (P.G.); (H.B.); (E.G.); (M.D.); (N.S.); (J.G.)
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Lai P, Zhang D, Xue JH, Xu S, Tian K, Zhang HZ, Wang B, Zhong YM, Liao YL. Current hotspot and study trend of transcatheter aortic valve replacement, a bibliometric analysis from 2009 to 2023. Front Cardiovasc Med 2025; 12:1411561. [PMID: 40297162 PMCID: PMC12034703 DOI: 10.3389/fcvm.2025.1411561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2024] [Accepted: 03/28/2025] [Indexed: 04/30/2025] Open
Abstract
Introduction Transcatheter aortic valve replacement (TAVR), alternatively termed transcatheter aortic valve implantation (TAVI), represents a seminal advancement in cardiovascular interventions by obviating the necessity for open-heart surgery traditionally associated with surgical aortic valve replacement (SAVR). This technique entails percutaneous delivery of a bioprosthetic valve. Despite the surfeit of literature on TAVR over the past fifteen years, a bibliometric analysis is conspicuously absent. Method A query executed on the Web of Science Core Collection (WoSCC) on September 1, 2022, returned 8,359 articles and reviews pertinent to TAVR. Data interpretation leveraged Microsoft Excel, CiteSpace, and VOSviewer to illustrate trends and delineate focal points within the corpus of TAVR research. Result The analysis incorporated 8,359 articles and reviews on TAVR from January 1, 2009, to August 1, 2023. Publication volume expanded from 35 in 2009 to a pinnacle in 2020, reflecting a near thirty folds increase, with citations escalating from 56 in 2009 to 27,354 in 2021. The United States prevailed in scholarly output (Np = 3,015), citation frequency (Nc = 70,991, excluding self-citations), and academic impact (H-index = 120). Columbia University was distinguished by the highest number of publications (Np = 380), citations (Nc = 41,051), and H-index (84). Within the author community, Rodes-Cabau J was preeminent, with 260 publications and an equivalent citation index and H-index. Keywords such as "balloon-expandable valve," "coronary access," "next-day discharge," "conducti on disturbances," and "coronary obstruction" have surfaced as the lexicon of burgeoning research themes. Conclusion Investigation into TAVR has emerged as a major area of scholarly focus. The United States stands at the forefront of this research. Columbia University ranks as the preeminent institution in terms of publication output. Key research themes such as "balloon-expandable valve," "coronary access," and "coronary obstruction" are shaping up as current and prospective research hotspots, signaling potential areas for future study and innovation.
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Affiliation(s)
- Ping Lai
- Department of Cardiology, First Affiliated Hospital of Gannan Medical University, Gannan Medical University, Ganzhou, Jiangxi, China
- Key Laboratory of Prevention and Treatment of Cardiovascular and Cerebrovascular Diseases, Ministry of Education, Gannan Medical University, Ganzhou, China
| | - Dekuan Zhang
- The First School of Clinical Medicine, Gannan Medical University, Ganzhou, Jiangxi, China
| | - Jin-hua Xue
- School of Basic Medicine, Gannan Medical University, Ganzhou, China
| | - Shuquan Xu
- The First School of Clinical Medicine, Gannan Medical University, Ganzhou, Jiangxi, China
| | - Kejun Tian
- Department of Cardiology, First Affiliated Hospital of Gannan Medical University, Gannan Medical University, Ganzhou, Jiangxi, China
| | - Hong-zhou Zhang
- Department of Cardiology, First Affiliated Hospital of Gannan Medical University, Gannan Medical University, Ganzhou, Jiangxi, China
| | - Bei Wang
- Department of Cardiology, First Affiliated Hospital of Gannan Medical University, Gannan Medical University, Ganzhou, Jiangxi, China
| | - Yi-ming Zhong
- Department of Cardiology, First Affiliated Hospital of Gannan Medical University, Gannan Medical University, Ganzhou, Jiangxi, China
- Key Laboratory of Prevention and Treatment of Cardiovascular and Cerebrovascular Diseases, Ministry of Education, Gannan Medical University, Ganzhou, China
| | - Yong-ling Liao
- Department of Cardiology, First Affiliated Hospital of Gannan Medical University, Gannan Medical University, Ganzhou, Jiangxi, China
- Key Laboratory of Prevention and Treatment of Cardiovascular and Cerebrovascular Diseases, Ministry of Education, Gannan Medical University, Ganzhou, China
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Bieliauskas G, Kobari Y, Khokhar AA, Abdel-Wahab M, Abdelhafez A, Fukui M, Kofoed KF, Dudek D, Fuchs A, Cavalcante J, Hayashida K, Tang GHL, Mylotte D, Bapat VN, Backer OD. Feasibility of redo-TAVI in the self-expanding ACURATE neo2 valve: a computed tomography study. EUROINTERVENTION 2024; 20:1405-1415. [PMID: 39552483 PMCID: PMC11556403 DOI: 10.4244/eij-d-24-00367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Accepted: 08/14/2024] [Indexed: 11/19/2024]
Abstract
BACKGROUND Redo-transcatheter aortic valve implantation (TAVI) may be unfeasible because of the risk of compromising coronary flow or coronary access by the pinned back leaflets of the index transcatheter aortic valve. AIMS We aimed to evaluate the feasibility of redo-TAVI using the balloon-expandable SAPIEN 3 (S3) implanted within the self-expanding ACURATE neo2 (ACn2) valve and to identify predictors associated with a high risk of compromising coronary flow. METHODS A total of 153 post-ACn2 TAVI cardiac computed tomography scans were analysed. Redo-TAVI using an S3 was simulated in two positions: S3 outflow to the ACn2 upper crown (low implant) and S3 outflow to the base of the ACn2 commissural posts (high implant). The risk for coronary flow compromise and inaccessibility was determined by the height of the neoskirt created by the pinned back leaflets and the valve-to-aorta distances. RESULTS At a low S3 implant position, risk of coronary flow compromise was predicted in only 8% of patients and this increased to 60% with a high S3 position. In accordance, coronary access was predicted to be unrestricted in 52% versus 13% of patients with a low versus high S3 implantation. Female sex, a small aortic annular dimension and a sinotubular junction-to-aortic annulus mean diameter ratio <1.15 were independent predictors associated with a high risk for coronary flow compromise. CONCLUSIONS The feasibility of redo-TAVI with an S3 in an ACn2 depends on the implant depth of the S3 and the geometry of the surrounding aorta. A low S3 implant may reduce the risk of coronary flow compromise and inaccessibility.
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Affiliation(s)
| | - Yusuke Kobari
- The Heart Center, Rigshospitalet, Copenhagen, Denmark
| | - Arif A Khokhar
- The Heart Center, Rigshospitalet, Copenhagen, Denmark
- Department of Cardiology, Hammersmith Hospital, Imperial College Healthcare NHS Trust London, London, United Kingdom
| | | | | | - Miho Fukui
- Minneapolis Heart Institute Foundation, Minneapolis, MN, USA
| | | | - Dariusz Dudek
- Jagiellonian University Medical College, Kraków, Poland
| | - Andreas Fuchs
- The Heart Center, Rigshospitalet, Copenhagen, Denmark
| | - Joao Cavalcante
- Minneapolis Heart Institute Foundation, Minneapolis, MN, USA
| | - Kentaro Hayashida
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
| | - Gilbert H L Tang
- Department of Cardiovascular Surgery, Mount Sinai Health System, New York, NY, USA
| | - Darren Mylotte
- Department of Cardiology, Galway University Hospital, Galway, Ireland
| | - Vinayak N Bapat
- Minneapolis Heart Institute Foundation, Minneapolis, MN, USA
| | - Ole De Backer
- The Heart Center, Rigshospitalet, Copenhagen, Denmark
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5
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Meier D, Akodad M, Fournier S, Sellers SL. Challenges in Coronary Access After Valve-in-Valve Transcatheter Aortic Valve Replacement: Is Bench Testing Part of the Solution? Can J Cardiol 2024; 40:2021-2024. [PMID: 39147323 DOI: 10.1016/j.cjca.2024.08.268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2024] [Revised: 08/08/2024] [Accepted: 08/09/2024] [Indexed: 08/17/2024] Open
Affiliation(s)
- David Meier
- Department of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland; Cardiovascular Translational Laboratory, St Paul's Hospital and University of British Columbia Centre for Heart Lung Innovation, Vancouver, British Columbia, Canada.
| | - Mariama Akodad
- Institut Cardiovasculaire Paris-Sud (ICPS), Hôpital Privé Jacques Cartier, Ramsay-Santé, Massy, France. https://twitter.com/myriam_akodad
| | - Stephane Fournier
- Department of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland. https://twitter.com/SFournierMD
| | - Stephanie L Sellers
- Cardiovascular Translational Laboratory, St Paul's Hospital and University of British Columbia Centre for Heart Lung Innovation, Vancouver, British Columbia, Canada; Centre for Cardiovascular Innovation, University of British Columbia, Vancouver, British Columbia, Canada. https://twitter.com/sellers_steph
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Völz S, Petursson P, Ioanes D, Råmunddal T, Angerås O. Navitor™ in Evolut™: a case report illustrating a novel approach to redo-transcatheter aortic valve implantation. Eur Heart J Case Rep 2024; 8:ytae577. [PMID: 39525513 PMCID: PMC11544423 DOI: 10.1093/ehjcr/ytae577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2024] [Revised: 07/02/2024] [Accepted: 10/21/2024] [Indexed: 11/16/2024]
Abstract
Background Transcatheter aortic valve implantation (TAVI) is expanding to younger patients, and the management of valve failure is a growing clinical problem. The transcatheter heart valve (THV) of choice for redo-TAVI is a complex decision, and first reports have examined the use of the Sapien 3™ THV (Edwards Lifesciences; Irvine, CA, USA) in failed Evolut™ (Medtronic, Minneapolis, MN, USA) THV. However, several different technical approaches may be worth consideration, and the subject remains a matter of debate. Case summary A 73-year-old female with previous coronary artery bypass grafting, percutaneous coronary intervention (PCI), and TAVI with a 26 mm Evolut™ R THV presented with signs of heart failure. The clinical investigation revealed a severe restenosis of the THV valve and a stenosis of the left coronary main stem. The patient was successfully treated with PCI of the left main and, during the same procedure, underwent implantation of a 25 mm Navitor™ THV (Abbott; Chicago, IL, USA). Discussion This case presentation aims to illustrate the rationale of and necessary conditions for performing a TAVI-in-TAVI procedure with Navitor™ THV in a failed Evolut™ THV which, to our best knowledge, constitutes a novel approach to redo-TAVI.
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Affiliation(s)
- Sebastian Völz
- Department of Cardiology, Sahlgrenska University Hospital, Blå Stråket 5, 41345 Gothenburg, Sweden
- Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Bruna Stråket 16, 41345 Gothenburg, Sweden
| | - Petur Petursson
- Department of Cardiology, Sahlgrenska University Hospital, Blå Stråket 5, 41345 Gothenburg, Sweden
- Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Bruna Stråket 16, 41345 Gothenburg, Sweden
| | - Dan Ioanes
- Department of Cardiology, Sahlgrenska University Hospital, Blå Stråket 5, 41345 Gothenburg, Sweden
| | - Truls Råmunddal
- Department of Cardiology, Sahlgrenska University Hospital, Blå Stråket 5, 41345 Gothenburg, Sweden
- Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Bruna Stråket 16, 41345 Gothenburg, Sweden
| | - Oskar Angerås
- Department of Cardiology, Sahlgrenska University Hospital, Blå Stråket 5, 41345 Gothenburg, Sweden
- Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Bruna Stråket 16, 41345 Gothenburg, Sweden
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Jahangiri M, Prendergast B. Management of bicuspid aortic valve disease in the transcatheter aortic valve implantation era. Heart 2024; 110:1291-1297. [PMID: 39117383 DOI: 10.1136/heartjnl-2024-324054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2024] [Accepted: 07/23/2024] [Indexed: 08/10/2024] Open
Abstract
In an era of rapidly expanding use of transcatheter aortic valve implantation (TAVI), the management of patients with bicuspid aortic valve (BAV) disease is far less well established than in those with trileaflet anatomy. Results of isolated surgical aortic valve replacement are excellent in suitable patients, and surgery also allows treatment of concomitant pathology of the aortic root and ascending aorta that is frequently encountered in this cohort. Conversely, TAVI provides an excellent alternative in older patients who may be unsuitable for surgery, although outcomes in BAV disease have only been reported in relatively small non-randomised series. Here, we discuss the pertinent literature on this topic and outline contemporary interventional treatment options in this challenging setting.
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Affiliation(s)
- Marjan Jahangiri
- Department of Cardiac Surgery, St George's University Hospitals NHS Foundation Trust, London, UK
| | - Bernard Prendergast
- Department of Cardiology, Guy's and St Thomas' NHS Foundation Trust, London, UK
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Beneduce A, Khokhar AA, Curio J, Giannini F, Zlahoda-Huzior A, Grant D, Lynch L, Zakrzewski P, Kim WK, Maisano F, de Backer O, Dudek D. Impact of leaflet splitting on coronary access after redo-TAVI for degenerated supra-annular self-expanding platforms. EUROINTERVENTION 2024; 20:e770-e780. [PMID: 38887883 PMCID: PMC11163438 DOI: 10.4244/eij-d-24-00107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Accepted: 03/20/2024] [Indexed: 06/20/2024]
Abstract
BACKGROUND Coronary access (CA) is a major concern in redo-transcatheter aortic valve implantation (TAVI) for failing supra-annular self-expanding transcatheter aortic valves (TAVs). AIMS This ex vivo study evaluated the benefit of leaflet splitting (LS) on subsequent CA after redo-TAVI in anatomies deemed at high risk of unfeasible CA. METHODS Ex vivo, patient-specific models were printed three-dimensionally. Index TAVI was performed using ACURATE neo2 or Evolut PRO (TAV-1) at the standard implant depth and with different degrees of commissural misalignment (CMA). Redo-TAVI was performed using the balloon-expandable SAPIEN 3 Ultra (TAV-2) at different implant depths with commissural alignment. Selective CA was attempted for each configuration before and after LS in a pulsatile flow simulator. The leaflet splay area was assessed on the bench. RESULTS In matched comparisons of 128 coronary cannulations across 64 redo-TAVI configurations, the overall feasibility of CA significantly increased after LS (60.9% vs 18.7%; p<0.001). The effect of LS varied according to the sinotubular junction height, TAV-1 design, TAV-1 CMA, and TAV-2 implant depth, given TAV-2 alignment. LS enabled CA for up to CMA 45° with the ACURATE neo2 TAV-1 and up to CMA 30° with the Evolut PRO TAV-1. The combination of LS and a low TAV-2 implant provided the highest feasibility of CA after redo-TAVI. The leaflet splay area ranged from 25.60 mm2 to 37.86 mm2 depending on the TAV-1 platform and TAV-2 implant depth. CONCLUSIONS In high-risk anatomies, LS significantly improves CA feasibility after redo-TAVI for degenerated supra-annular self-expanding platforms. Decisions on redo-TAVI feasibility should be carefully individualised, taking into account the expected benefit of LS on CA for each scenario.
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Affiliation(s)
| | - Arif A Khokhar
- Cardiology, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom
- Clinical Research Center Intercard, Kraków, Poland
| | - Jonathan Curio
- Department of Cardiology, Heart Center Cologne, University of Cologne, Faculty of Medicine and University Hospital, Cologne, Germany
| | | | - Adriana Zlahoda-Huzior
- Clinical Research Center Intercard, Kraków, Poland
- Department of Measurement and Electronics, AGH University of Science and Technology, Kraków, Poland
| | - Daire Grant
- Boston Scientific Corporation, Marlborough, MA, USA
| | - Lisa Lynch
- Boston Scientific Corporation, Marlborough, MA, USA
| | | | | | - Francesco Maisano
- Heart Valve Center, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Ole de Backer
- Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Dariusz Dudek
- Digital Medicine & Robotics Center, Jagiellonian University Medical College, Kraków, Poland
- Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy
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9
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Khokhar AA, Curio J, Sticchi A, Hartley A, Demir OM, Ruparelia N. Transcatheter Aortic Valve Implantation to Treat Degenerated Aortic, Mitral and Tricuspid Bioprosthesis. J Clin Med 2024; 13:592. [PMID: 38276098 PMCID: PMC10816283 DOI: 10.3390/jcm13020592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 01/06/2024] [Accepted: 01/12/2024] [Indexed: 01/27/2024] Open
Abstract
Transcatheter aortic valve implantation (TAVI) is now well established as the treatment of choice for patients with native aortic valve stenosis who are high or intermediate risk for surgical aortic valve replacement. Recent data has also supported the use of TAVI in patients at low surgical risk and also in anatomical subsets that were previously felt to be contra-indicated including bicuspid aortic valves and aortic regurgitation. With advancements and refinements in procedural techniques, the application of this technology has now been further expanded to include the management of degenerated bioprosthesis. After the demonstration of feasibility and safety in the management of degenerated aortic bioprosthetic valves, mitral and tricuspid bioprosthetic valve treatment is now also well-established and provides an attractive alternative to performing redo surgery. In this review, we appraise the latest clinical evidence and highlight procedural considerations when utilising TAVI technology in the management of degenerated aortic, mitral or tricuspid prosthesis.
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Affiliation(s)
- Arif A. Khokhar
- Cardiology, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London W12 0HS, UK; (A.A.K.); (A.H.)
| | - Jonathan Curio
- Department of Cardiology, Heart Center Cologne, Faculty of Medicine, University Hospital, University of Cologne, 50937 Cologne, Germany;
| | - Alessandro Sticchi
- Cardiac Catheterisation Laboratory, Cardiothoracic and Vascular Department, Azienda Ospedaliero Universitaria Pisana, 56126 Pisa, Italy;
- Università di Pisa, Lungarno Pacinotti 43, 56126 Pisa, Italy
| | - Adam Hartley
- Cardiology, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London W12 0HS, UK; (A.A.K.); (A.H.)
| | - Ozan M. Demir
- Department of Cardiology, Essex Cardiothoracic Centre, Mid and South Essex NHS Foundation Trust, Basildon SS16 5NL, UK
| | - Neil Ruparelia
- Cardiology, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London W12 0HS, UK; (A.A.K.); (A.H.)
- Cardiology, Royal Berkshire Hospital, Reading RG1 5AN, UK
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10
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Almarzooq ZI, Shah PB. CT Simulation for Redo-TAVR: Can We Predict Future Coronary Access? Circ Cardiovasc Interv 2023; 16:e013572. [PMID: 37988441 DOI: 10.1161/circinterventions.123.013572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2023]
Affiliation(s)
- Zaid I Almarzooq
- Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, MA
| | - Pinak B Shah
- Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, MA
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