Transcatheter Valve Neo-Commissural Overlap With Coronary Orifices After Transcatheter Aortic Valve Replacement
Key result
TAVR results in severe neo-commissure overlap with coronary orifices in ~51% of patients across valve types.
- n=70
Why the study?
As TAVR indications expand, the frequency and extent of neo-commissural overlap with coronary orifices and its impact on coronary reaccess remain to be characterized.
Population
70 patients with symptomatic severe aortic stenosis undergoing TAVR with pre- and post-procedure multidetector computed tomography
Comparison
Balloon-expandable valves versus self-expanding valves regarding neo-commissural overlap with coronary orifices
Design
Retrospective observational cohort study
Follow-up
2.9±3.7 months post-TAVR
Authors
Discussion
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Member takes
Implication
May complicate future coronary reaccess after TAVR; hypothesis-generating for alignment strategies, needing prospective trials.
Study Design
Type
Observational (n=70)
Multicenter
No
Structured PICO
P
Population
70 patients with symptomatic severe aortic stenosis who underwent TAVR and had pre- and post-procedure multidetector computed tomography evaluated at a mean of 2.9 months.
E
Exposure
Transcatheter aortic valve replacement (TAVR) using various valve types (11 Sapien, 17 Sapien XT, 25 Sapien 3, 17 CoreValve/Evolut R)
O
Outcome
Frequency and extent of overlap between neo-commissure and coronary orifices (categorized as severe [0°-20.0°], moderate [20.1°-40.0°], and mild [40.1°-60.0°])surrogate
Over half of patients undergoing TAVR have severe overlap between valve neo-commissures and coronary orifices, which may complicate future coronary reaccess.
Cite This Study
Tang et al. (2018) conducted an observational in Symptomatic severe aortic stenosis (n=70). Transcatheter aortic valve replacement (TAVR) was evaluated on Severe overlap between neo-commissure and either or both coronary orifices. Following TAVR, 51.4% of patients had severe overlap between neo-commissures and either or both coronary orifices, with no significant differences between balloon-expandable and self-expanding valves.