Transcatheter aortic valve replacement or TAVR has become the gold standard for the treatment of symptomatic and severe aortic valve stenosis in elderly patients. Although the role of computed tomography imaging was initially limited to the determination of the optimal vascular approach, it has progressively matured to become the pilar of TAVR work-up while being standardized by consensus conferences. The list of evaluated elements includes aortic annulus diameter, the optimal projection curve, the number of aortic leaflets, the severity and localization of calcifications, coronary ostial height, membranous septum length and aortic angulation. The proper and cautious evaluation of these elements may help evaluating the risk for the main periprocedural complications such as coronary obstruction, annular rupture, permanent pacemaker implantation or procedural failure and selecting the optimal transcatheter heart valve and its size, according to the patient's specific anatomy. In this review, we detail how the evaluation of these parameters may impact the selection of the transcatheter heart valve.
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http://dx.doi.org/10.1016/j.ancard.2022.10.001 | DOI Listing |
J Investig Med High Impact Case Rep
January 2025
The University of the West Indies, St. Augustine, Trinidad and Tobago.
We describe a 30-year-old Caribbean-Black woman with a clinical presentation suggestive of a transient ischemic attack (TIA) with no conventional cerebrovascular risk factors, albeit with a newly diagnosed quadricuspid aortic valve (QAV) with moderate aortic regurgitation (AR). Although QAV is a recognized congenital cardiac defect, its association with TIA remains elusive. This case highlights the importance of considering potential atypical etiologies, such as QAV, in the evaluation and management of young patients presenting with cerebrovascular events.
View Article and Find Full Text PDFTher Adv Cardiovasc Dis
January 2025
Department of Cardiac Surgery, LMU University Hospital, Ludwig Maximilian University, Munich, Germany.
Background: Extensive surgical resection of the thoracic aorta in patients with type A aortic dissection (TAAD) is thought to reduce the risk of late aortic wall degeneration and the need for repeat aortic operations.
Objectives: We evaluated the early and late outcomes after aortic root replacement and supracoronary ascending aortic replacement in patients with TAAD involving the aortic root.
Design: Retrospective, multicenter cohort study.
Catheter Cardiovasc Interv
January 2025
Hackensack University Medical Center, Hackensack, New Jersey, USA.
Background: Patients with prior history of chest or mediastinal radiation are deemed high risk for surgical AVR. Transcatheter aortic valve replacement (TAVR) has emerged as a promising alternative for these patients, however, this patient population was underrepresented in prior TAVR trials.
Aims: To compare the outcomes of TAVR in patients with versus without a history of prior chest or mediastinal radiation.
Angiology
January 2025
Department of Cardiovascular Surgery, Shizuoka Medical Center, Shizuoka, Japan.
This meta-analysis evaluates outcomes in patients undergoing bioprosthetic aortic valve replacement (bAVR), comparing different antithrombotic strategies. We conducted a systematic search through May 2024. A standard meta-analysis compared outcomes between patients who received anticoagulation therapy (AC) and those who did not.
View Article and Find Full Text PDFCirc Cardiovasc Interv
January 2025
Section of Interventional Cardiology, MedStar Washington Hospital Center, DC (R.V., K.R.C., I.M., I.B.-D., L.F.S., R.W., T.R.).
Some patients with aortic stenosis may require multiple valve interventions in their lifetime, and choosing transcatheter aortic valve replacement (TAVR) as the initial intervention may be appealing to many. If their transcatheter heart valve degenerates later in life, most will hope to undergo redo-TAVR. However, if redo-TAVR is not feasible, some may have to undergo surgical explantation of their transcatheter heart valve (TAVR-explant).
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