What Are the Implications of Choosing a TAVR-First Strategy in the Lifetime Management of Aortic Stenosis?: A Critical Review of TAVR-Explant- and Redo-TAVR

Circulation Cardiovascular Interventions, Год журнала: 2025, Номер unknown

Опубликована: Янв. 22, 2025

Some patients with aortic stenosis may require multiple valve interventions in their lifetime, and choosing transcatheter replacement (TAVR) as the initial intervention be appealing to many. If heart degenerates later life, most will hope undergo redo-TAVR. However, if redo-TAVR is not feasible, some have surgical explantation of (TAVR-explant). With rising numbers TAVR younger patients, we address practical implications a TAVR-first strategy. In this review explore potential factors contributing higher-than-expected mortality after TAVR-explant, synthesize available outcomes data for TAVR-explant structurally degenerated valves, describe strategies standardize optimize techniques TAVR-explant. We also discuss clinical within context limitations currently published series highlight benefit virtual planning assess feasibility future before implanting first valve. Finally, areas investigation inform management who interventions.

Язык: Английский

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Head-to-head comparison of balloon-expandable transcatheter heart valves

The Lancet, Год журнала: 2025, Номер unknown

Опубликована: Апрель 1, 2025

Язык: Английский

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MANAGEMENT OF ASYMPTOMATIC SEVERE AORTIC STENOSIS: A CRITICAL REVIEW OF GUIDELINES AND CLINICAL OUTCOMES

American Heart Journal, Год журнала: 2025, Номер unknown

Опубликована: Апрель 1, 2025

Язык: Английский

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Redo-Transcatheter Aortic Valve Replacement Procedural Optimization and Patient Selection: From Bench to Clinical Practice

Journal of Clinical Medicine, Год журнала: 2025, Номер 14(8), С. 2770 - 2770

Опубликована: Апрель 17, 2025

With recent guidelines expanding transcatheter aortic valve replacement (TAVR) to younger patients, indications for redo-TAVR will also likely increase. When compared with TAVR, is a rare and novel procedure. Current clinical data derived from registries suggest excellent safety, low rates of 30-day 1-year mortality following redo-TAVR. Proper understanding bench studies regarding optimal configurations, patient anatomy the technical properties heart valves (THV) essential selection procedural success. Lifetime management should start before index procedure, as choice THV has major impact on feasibility Procedural optimization by adequate sizing, commissural alignment implant depth both redo-THV are critical determinants hemodynamics maximized longevity, well lifelong coronary access.

Язык: Английский

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Management of difficult coronary anatomy during transcatheter aortic valve implantation: what are the key issues?

Current Opinion in Cardiology, Год журнала: 2025, Номер unknown

Опубликована: Апрель 25, 2025

Predicting and preventing coronary obstruction in transcatheter aortic valve replacement (TAVR) is crucial due to its high mortality risk. In native TAVR, predicting requires assessing cusp height, artery valve-to-coronary distance, leaflet calcium volume. The VIVID classification has been proposed for evaluating the risk of TAVR failed bioprosthetic surgical valves. After with Sapien 3 valve, feasibility redo access decreases a shallower implantation initial 3. within an Evolut positioning outflow at node 4 improves accessibility compared nodes 5 or 6. For sizing 3, in-vivo CT results smaller sizes than bench sizing, reducing improving feasibility. Leaflet modification stenting techniques dedicated leaflet-splitting device have maintain perfusion high-risk cases. Coronary preservation remains significant challenge, requiring further research into preprocedural planning strategies.

Язык: Английский

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Decision-Making Approach to the Treatment of Young and Low-Risk Patients With Aortic Stenosis

КАРДИОЛОГИЯ УЗБЕКИСТАНА, Год журнала: 2024, Номер 17(21), С. 2455 - 2471

Опубликована: Ноя. 1, 2024

Язык: Английский

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Conduction Disturbances After Transcatheter Aortic Valve Replacement

КАРДИОЛОГИЯ УЗБЕКИСТАНА, Год журнала: 2024, Номер 17(22), С. 2575 - 2595

Опубликована: Ноя. 1, 2024

Язык: Английский

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In Vivo Frame Geometry of the Navitor Intra-Annular Self-Expanding Valve

КАРДИОЛОГИЯ УЗБЕКИСТАНА, Год журнала: 2024, Номер 18(1), С. 138 - 140

Опубликована: Дек. 4, 2024

Язык: Английский

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