CBS 2019
CBSMD教育中心
中 文

经导管主动脉瓣置换

Abstract

Recommended Article

Chimney technique in a TAVR-in-TAVR procedure with high risk of left main artery ostium occlusion Suture- or Plug-Based Large-Bore Arteriotomy Closure: A Pilot Randomized Controlled Trial Relationship Between Hospital Surgical Aortic Valve Replacement Volume and Transcatheter Aortic Valve Replacement Outcomes Bioprosthetic valve oversizing is associated with increased risk of valve thrombosis following TAVR Prognostic implications of baseline 6‐min walk test performance in intermediate risk patients undergoing transcatheter aortic valve replacement Incidence and Outcomes of Surgical Bailout During TAVR : Insights From the STS/ACC TVT Registry Outcomes 2 Years After Transcatheter Aortic Valve Replacement in Patients at Low Surgical Risk Prior Balloon Valvuloplasty Versus Direct Transcatheter Aortic Valve Replacement: Results From the DIRECTAVI Trial
|<<... 2 3 4 5 6 7 8 ...>>|

Original ResearchVolume 13, Issue 6, March 2020

JOURNAL：JACC Cardiovasc Interv. Article Link

Feasibility of Coronary Access and Aortic Valve Reintervention in Low-Risk TAVR Patients

T Rogers, BC Greenspun, G Weissman et al. Keywords: coronary access; coronary artery obstruction; PCI; TAVR; valve-in-valve

ABSTRACT

OBJECTIVES - The aim of this study was to evaluate the feasibility of coronary access and aortic valve reintervention in low-risk patients undergoing transcatheter aortic valve replacement (TAVR) with a balloon-expandable transcatheter heart valve (THV).

 

BACKGROUND - Younger, low-risk TAVR patients are more likely than older, higher risk patients to require coronary angiography, percutaneous coronary intervention, or aortic valve reintervention, but their THVs may impede coronary access and cause coronary obstruction during TAVR-in-TAVR.

 

METHODS - The LRT (Low Risk TAVR) trial (NCT02628899) enrolled 200 subjects with symptomatic severe aortic stenosis to undergo TAVR using commercially available THVs. Subjects who received balloon-expandable THVs and who had 30-day cardiac computed tomographic scans were included in this study. In a subgroup, the feasibility of intentional THV crimping on the delivery catheter to pre-determine commissural alignment was tested.

 

RESULTS - In the LRT trial, 168 subjects received balloon-expandable THVs and had 30-day cardiac computed tomographic scans, of which 137 were of adequate image quality for analysis. The most challenging anatomy for coronary access (THV frame above and commissural suture post in front of a coronary ostium) was observed in 9% to 13% of subjects. Intentional THV crimping did not appear to meaningfully affect commissural alignment. The THV frame extended above the sinotubular junction in 21% of subjects, and in 13%, the distance between the THV and the sinotubular junction was <2 mm, signifying that TAVR-in-TAVR may not be feasible without causing coronary obstruction.

 

CONCLUSIONS - TAVR may present challenges to future coronary access and aortic valve reintervention in a substantial number of low-risk patients.

>CBS CBS 2019

> CBS 2019 REGISTRATION

> CBS 2019 PROGRAM

> CBS 2019 CALL FOR SCIENCE

> CBS 2019 SPOTLIGHTS

 CBSMD

> CBSMD WEBSITE REGISTRATION

> EDUCATION CENTER

> RECOMMANDED PAPER

> TOP 10 RESEARCH PAPER

> PRE-READING

CBS 2019 CBS 2019 FACULTY Education Resource CBSMD Scientific Library
Copyright ⓒ CBS MD Nanjing China. All rights reserved. 京ICP备16025898号-11
联系我们| Top