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Commissural alignment in the Evolut TAVR procedure: conventional versus hat marker-guided shaft rotation methods.
AsiaIntervention
September 2023
Department of Cardiology, Tokyo Women's Medical University, Shinjuku, Tokyo, Japan.
Background: Coronary cannulation after TAVR is sometimes difficult due to an overlap between native and neo-commissures, especially in Evolut devices with a supra-annular position. The Evolut C-tab corresponds to a neo-commissure, and the hat marker is in a fixed position. Therefore, the orientation of the hat marker can be adjusted to minimise overlaps.
View Article and Find Full Text PDFFirst-in-Human Multicenter Experience of the Newest Generation Supra-Annular Self-Expanding Evolut FX TAVR System.
JACC Cardiovasc Interv
July 2023
Mount Sinai Hospital, New York, New York, USA. Electronic address:
Article Synopsis
- The Evolut FX TAVR system from Medtronic is a new heart valve replacement method that has shown improvements over older versions, but not many people have used it yet.
- In a study, 226 patients had this procedure done, mostly for a condition called aortic stenosis, and the results were analyzed after 30 days.
- The study found that the Evolut FX system had fewer problems and worked better in terms of fitting the valve correctly and using less complicated methods compared to the earlier Evolut PRO+ system.
Conventional versus modified delivery system technique in commissural alignment from the Evolut low-risk CT substudy.
Catheter Cardiovasc Interv
February 2022
Department of Cardiovascular Surgery, Houston Methodist DeBakey Heart and Vascular Center, Houston, Texas, USA.
Objectives: We assessed the impact of conventional delivery system (DS) insertion technique on "Hat-marker" orientation/commissural alignment in patients who underwent transcatheter aortic valve replacement (TAVR) in the Evolut Low Risk Trial CT substudy versus a modified technique.
Background: Unlike surgical aortic valve replacement, where alignment of the surgical valve commissures with native commissures can be achieved virtually 100% of the time, commissural alignment during TAVR is not achieved consistently. This may subsequently impact the feasibility of both coronary access and reintervention after TAVR.
Lateral Approach for Modifying Hat-Marker Orientation to Minimize Neo-Commissural Overlap During Transcatheter Aortic Valve Replacement.
JACC Cardiovasc Interv
November 2020
Department of Cardiology, Kurashiki Central Hospital, Kurashiki, Japan.
Alignment of Transcatheter Aortic-Valve Neo-Commissures (ALIGN TAVR): Impact on Final Valve Orientation and Coronary Artery Overlap.
JACC Cardiovasc Interv
May 2020
Division of Cardiac Surgery, NewYork-Presbyterian Hospital, Columbia University Medical Center, New York, New York.
Objectives: The aim of this study was to evaluate the impact of initial deployment orientation of SAPIEN 3, Evolut, and ACURATE-neo transcatheter heart valves on their final orientation and neocommissural overlap with coronary arteries.
Background: Coronary artery access and redo transcatheter aortic valve replacement (TAVR) following initial TAVR may be influenced by transcatheter heart valve orientation. In this study the impact of transcatheter heart valve deployment orientation on commissural alignment was evaluated.
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