Key result
CT-based TAVR sizing recommends prostheses up to ~6 mm larger than those implanted during SAVR.
Why the study?
Valve prosthesis selection is a crucial aspect of TAVR and SAVR, prompting assessment of consistency between intraprocedural SAVR sizing and CCT-based TAVR simulation sizing.
Does TAVR sizing simulation based on CCT differ from actual SAVR prosthesis sizing in patients with aortic stenosis?
Observational (n=167)
Single-blind
No
Does TAVR sizing simulation based on CCT differ from actual SAVR prosthesis sizing in patients with aortic stenosis?
Effect estimate: Mean difference of 6.4 mm (self-expanding) and 4.5 mm (balloon-expandable)
TAVR sizing based on CCT systematically recommends larger prostheses compared to those actually implanted during SAVR, which may have implications for prosthesis-patient mismatch.
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May raise mismatch risk if CT-TAVR sizing guides SAVR; hypothesis-generating and requires prospective validation before practice change.
Jastrzebski et al. (2023) conducted an observational in Severe symptomatic aortic stenosis (n=167). TAVR sizing simulation based on CCT vs. SAVR intraoperative sizing was evaluated on Difference in aortic valve prosthesis size selection between TAVR simulation and SAVR (Mean difference of 6.4 mm (self-expanding) and 4.5 mm (balloon-expandable)). Simulated transcatheter aortic valve replacement sizing based on computed tomography recommended larger prostheses than those actually implanted during surgical aortic valve replacement, with an average difference of 6.4 mm for self-expanding and 4.5 mm for balloon-expandable valves.
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