Transcatheter aortic valve replacement (TAVR) has become the standard option for high risk patients with bioprosthetic valve degeneration. However, percutaneous coronary interventions after TAVR may be challenging as the manipulation and engagement of the guiding catheters is much more limited and difficult, due to the superimposition of the metallic frame of the TAVR valve upon the bioprosthetic cage. We describe a case of percutaneous coronary intervention in a patient with history of transcatheter aortic valve implantation after bioprosthetic valve degeneration and we describe a new method for accessing coronary arteries in cases of TAVR-in-surgical aortic valve replacement with a high-frame TAVR with a supra-annular leaflet position, by using the route outside the frame. 〈 We describe a method for accessing coronary arteries in cases of transcatheter aortic valve implantation (TAVI)-in-surgical aortic valve replacement with a high-frame TAVI with a supraannular leaflet position, by using the route outside the frame.〉.
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http://dx.doi.org/10.1016/j.jccase.2020.04.005 | DOI Listing |
Catheter Cardiovasc Interv
January 2025
IRCCS Pol. S. Donato, Milan, Italy.
Transfemoral transcatheter aortic valve Replacement (TAVR) has become the standard therapy for patients with severe aortic stenosis in patients over 75 years old in Europe or 65 years old in the United States, regardless of the surgical risk. Furthermore, iterations of existing transcatheter aortic valves (TAVs), as well as devices with novel concepts, have provided substantial improvements with respect to the limitations of previous-generation devices. Hence, treatment of a broader spectrum of patients has become feasible, and a sophisticated selection of the appropriate TAV tailored to patients' anatomy and comorbidities is now possible.
View Article and Find Full Text PDFMultimed Man Cardiothorac Surg
January 2025
Department of Cardiothoracic Surgery, Faculty of Medicine, Mansoura University Mansoura, Egypt.
The Ross procedure continues to be the best procedure to address unrepairable aortic valve pathology, especially in young adults. The Achilles heel of this procedure has been aortic root dilation and the potential need for a reoperation that may be associated with slightly increased risks in addition to the need for intervention on the pulmonary outflow tract. Modifying the Ross procedure by autograft inclusion inside a Dacron graft seems to have the potential advantage of stabilizing the autograft diameter, which may be associated with improved durability and decrease the need for future intervention.
View Article and Find Full Text PDFJ Cardiovasc Dev Dis
January 2025
Department of Cardiology, National University Heart Centre Singapore, 5 Lower Kent Ridge Road, Singapore 119074, Singapore.
Background: Severe aortic stenosis (AS) stratified by sex has been increasingly studied in the European population. Sex-specific outcomes in Asian patients with AS remain poorly defined. Hence, we aimed to study the clinical characteristics and impact of sex in moderate-to-severe AS, undergoing both invasive and conservative interventions in an Asian cohort over 10 years.
View Article and Find Full Text PDFJ Cardiovasc Dev Dis
January 2025
Cardiovascular Center, Cathay General Hospital, Taipei 106, Taiwan.
Background: A staging system based on cardiac damage for severe aortic stenosis (AS) has been validated for prognosis prediction following transcatheter aortic valve replacement (TAVR). Our study aims to investigate whether TAVR can lead to changes in cardiac damage shortly after the procedure and how these changes impact prognosis.
Method: Patients in this retrospective cohort study were classified into five stages (0-4) before TAVR based on the echocardiographic findings of cardiac damage.
J Cardiovasc Dev Dis
December 2024
Department of Cardiothoracic and Vascular Surgery, Montefiore Medical Center, Bronx, NY 10467, USA.
The use of extracorporeal membrane oxygenation (ECMO) has emerged as a rescue intervention for hemodynamically unstable patients and prophylactic intraprocedural hemodynamic support in the cardiac catheterization laboratory. The prompt initiation of ECMO provides immediate hemodynamic support and allows for the completion of bridging and/or life-saving interventions. However, there are no clinical practice guidelines for the use of extracorporeal support in this area.
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