Key result
STJ-annulus diameter difference under ~3 mm predicts sinus sequestration risk in TAV-in-TAV.
Why the study?
The risk of coronary artery occlusion due to sinus of Valsalva sequestration in TAV-in-TAV procedures has been reported, but the risk in Japanese patients is unknown.
Observational (n=308)
No
May flag high-risk anatomy for sinus sequestration in TAV-in-TAV; leaves open prospective validation before guiding practice.
Background: Transcatheter aortic valve (TAV)-in-TAV is an attractive treatment for degenerated TAV. The risk of coronary artery occlusion due to sequestration of the sinus of Valsalva (SOV) in TAV-in-TAV has been reported, but the risk in Japanese patients is unknown. This study aimed to investigate the proportion of Japanese patients who are expected to experience difficulty with the second TAV implantation (TAVI) and evaluate the possibility of reducing the risk of coronary artery occlusion.
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Sato et al. (2023) conducted an observational in Severe aortic stenosis in patients who underwent prior TAVI (n=308). Difference between mean STJ diameter and area-derived annulus diameter ≤3.0 mm vs. Difference >3.0 mm was evaluated on Prediction of sinus sequestration risk based on the difference between mean STJ diameter and area-derived annulus diameter (AUC 0.74). A difference of 3.0 mm or less between the mean STJ diameter and the area-derived annulus diameter predicted a high risk of sinus sequestration during TAV-in-TAV with an area under the curve of 0.74.
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