Transcatheter aortic valve replacement (TAVR) is mainly performed using the transfemoral (TF) approach. If the TF approach is difficult, the transapical (TA) or transaortic (TAo) approach is used; however, the complication rate is higher in such cases. In this case, abdominal aortic aneurysm (AAA) replacement and TAVR via artificial vessels were performed simultaneously because of anatomical difficulties in stent graft implantation and TF-TAVR for severe aortic stenosis (AS) associated with AAA. Performing TAVR simultaneously with AAA replacement avoids TA- or TAo-TAVR and allows for postoperative management in the absence of AS. Additionally, there is no need to create a new access for TAVR using artificial vessels. Since the long-term results of AAA are better with open surgery than with endovascular aneurysm repair and the age of indication for TAVR is expected to decrease due to valve-in-valve and other factors, simultaneous surgical AAA replacement and TAVR using a Y-graft vascular prosthesis is an effective treatment option when TF-TAVR is difficult to perform.
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http://dx.doi.org/10.1016/j.carrev.2022.06.010 | 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 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
Interventional Cardiology Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy.
Transcatheter aortic valve replacement (TAVR) in patients with severe aortic stenosis and raphe-type bicuspid aortic valve (BAV) is still associated with poor outcomes in terms of increased risk of paravalvular regurgitation, stroke, and permanent pacemaker implantation. There is no definitive consensus on the optimal sizing method for prosthesis selection in this setting. The LIRA method is a supra-annular tailored sizing method specifically designed for bicuspid anatomy that might increase accuracy of prosthesis choice in BAV patients and improve TAVR outcomes.
View Article and Find Full Text PDFCirc Cardiovasc Interv
January 2025
Centre for Cardiovascular Innovation, University of British Columbia, Vancouver, Canada. (A.H., J.J., S.O., K.M., J.A.L., P.B., D.A.W., S.L.S., J.G.W., J.S.).
Background: Transcatheter heart valve (THV) underexpansion after transcatheter aortic valve replacement may be associated with worse outcomes. THV expansion can be assessed fluoroscopically using a pigtail for calibration; however, the accuracy of this technique specific to transcatheter aortic valve replacement is unknown. We assessed the accuracy and reproducibility of a novel fluoroscopic method to assess THV expansion using the THV commissural post for calibration.
View Article and Find Full Text PDFCardiovasc Revasc Med
January 2025
Mount Sinai Fuster Heart Hospital, Icahn School of Medicine at Mount Sinai, New York, NY, USA. Electronic address:
Background: Patients with low-flow, low-gradient (LFLG) aortic stenosis (AS) have precarious hemodynamics and are a fragile population for intervention. Quantification of aortic valve calcification (AVC) severity is a critical component of the evaluation for transcatheter aortic valve replacement (TAVR); this study aims to further clarify its utility for risk stratification in LFLG AS.
Methods: This retrospective study evaluated 467 patients with LFLG AS undergoing TAVR at a large quaternary-care hospital from January 2019 to December 2021.
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