Coronary cannulation after transcatheter aortic valve replacement (TAVR) was unsuccessful in almost 10% of patients. This problem occurred almost exclusively in those who received a self-expanding valve. This study, recently published in JACC Cardiovasc Interv., was sought to investigate the feasibility of coronary ostia access after TAVR and describe potential predictors of coronary access impairment.…
Aligning Prosthetic Valves to Native Commissures: The Secret to Coronary Artery Obstruction?
Preventing coronary artery obstruction during transcatheter aortic valve replacement (TAVR) continues to be a challenge. There are techniques to prevent (or at least reduce) this from happening, which could be catastrophic. However, they all somehow fall into palliative care, that is, they will merely provide relief, rather than a cure. Commissure overlapping and the resulting…
TAVR in Small Annuli: Is There a Better Valve?
Transcatheter aortic valve replacement with the self-expandable valves has shown optimal clinical and electrocardiographic results in patients with small annuli. These supra-annular prosthetic valves seem somewhat better than the intra-annular balloon expandable. TAVR in general has better functional results in terms of patient/prosthesis mismatch. This seems especially true for patients with a small annulus. The…