Key result
Novel TAVR optimization strategies aim to reduce post-procedural complications and preserve coronary access.
Why the study?
As TAVR expands to younger and low surgical risk patients, there is a compelling need to identify patients at risk of post-procedural complications and optimize procedural techniques.
Optimization strategies such as the cusp-overlap technique and commissural alignment are crucial for minimizing complications and preserving coronary access during TAVR, especially as the procedure expands to younger, lower-risk patients.
As transcatheter aortic valve replacement (TAVR) rapidly expands to younger patients and those at low surgical risk, there is a compelling need to identify patients at increased risk of post-procedural complications, such as paravalvular leak, prosthesis-patient mismatch, and conduction abnormalities. This review highlights the incidence and risk factors of these procedural complications, and focuses on novel methods to reduce them by using newer generation transcatheter heart valves and the innovative cusp-overlap technique, which provides optimal fluoroscopic imaging projection to allow for precise implantation depth which minimizes interaction with the conduction system. Preserving coronary access after TAVR is another important consideration in younger patients. This paper reviews the significance of commissural alignment to allow coronary cannulation after TAVR and discusses recently published data on modified delivery techniques to improve commissural alignment.
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Siddique et al. (2022) conducted a review in Transcatheter aortic valve replacement. TAVR optimization strategies (cusp-overlap technique, commissural alignment) was evaluated. Novel TAVR optimization strategies, including the cusp-overlap technique and commissural alignment, aim to reduce post-procedural complications and preserve coronary access.
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