First-in-Man Large-Field Intravascular Ultrasound-Guided Transcatheter Aortic Valve Replacement

Intravascular Ultrasound-Guided Contrast-Free Transcatheter Aortic Valve Implantation: A Porcine Feasibility Study

“…31,32 Our findings agree with the above studies regarding the potential of IVUS for preimplantation evaluation. We demonstrated a procedure without prior computed tomography angiography, which might be useful if it is not available, if obtained images are suboptimal, or if the patient has a prohibitive impaired renal function, which is in agreement with Hakim et al and Leesar et al 35,38 The work presented here demonstrates a further progression by extending the IVUS guidance in conjunction with fluoroscopy to valve deployment without the need for aortic root angiography and assessment of the expanded valve in a porcine model. This approach would be beneficial for patients with impaired renal function undergoing TAVI to reduce the risk for AKI.…”

“…37 Most recently, Leesar et al reported the first case of IVUS-guided annulus-sizing and evaluation of femoral access where prior computed tomography angiography was prohibitive due to severe renal impairment, resulting in a procedure with only minimal used of contrast media during valve deployment. 38 These studies accentuate the potential of IVUS as an adjunct in TAVI to reduce contrast volume and risk for AKI. [33][34][35]37,38 However, they are mainly limited to preimplantation evaluation, with the exclusion of Roy et al who also assessed postimplantation valve leaflet function and frame expansion.…”

“…38 These studies accentuate the potential of IVUS as an adjunct in TAVI to reduce contrast volume and risk for AKI. [33][34][35]37,38 However, they are mainly limited to preimplantation evaluation, with the exclusion of Roy et al who also assessed postimplantation valve leaflet function and frame expansion. 31,32 Our findings agree with the above studies regarding the potential of IVUS for preimplantation evaluation.…”

“…37 Most recently, Leesar et al reported the first case of IVUS-guided annulus-sizing and evaluation of femoral access where prior computed tomography angiography was prohibitive due to severe renal impairment, resulting in a procedure with only minimal used of contrast media during valve deployment. 38…”