How to Avoid Coronary Occlusion During TAVR Valve-in-Valve Procedures

Valvo, Roberto; Costa, Giuliano; Barbanti, Marco

doi:10.3389/fcvm.2019.00168

Cited by 18 publications

(10 citation statements)

References 33 publications

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“…Coronary artery occlusion (CAO) has been reported as a rare but potentially lethal complication following SAVR, with a prevalence of 1%–5% of patients following SAVR 1–3 . This complication has also been reported after transcatheter aortic valve replacement and is usually associated with high mortality risk 4 …”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3] This complication has also been reported after transcatheter aortic valve replacement and is usually associated with high mortality risk. 4 Clinical syndromes typically manifest within the first 6 months of the procedure and can range from stable angina to acute coronary syndrome, ventricular arrhythmias, heart failure, and even sudden cardiac death. This is the first case report to our knowledge of wire externalization and conversion to antegrade technique via a coronary ostium which was compressed from the AVR with a successful result.…”

Section: Discussionmentioning

confidence: 99%

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Novel approach to stenting the left anterior descending coronary artery through a retrograde approach via the left internal mammary artery graft in a patient with occlusion of the coronary ostium from a prior aortic valve replacement

Soud,

Feit,

Rao

et al. 2023

Cathet Cardio Intervent

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Total occlusion of both coronary ostia is a rare and potentially life‐threatening complication following surgical aortic valve replacement. This report presents a case of a patient with known total occlusion of both coronary artery ostia following combined coronary artery bypass graft surgery and aortic valve replacement who underwent successful percutaneous coronary intervention through a retrograde approach.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Novel approach to stenting the left anterior descending coronary artery through a retrograde approach via the left internal mammary artery graft in a patient with occlusion of the coronary ostium from a prior aortic valve replacement

Soud,

Feit,

Rao

et al. 2023

Cathet Cardio Intervent

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show abstract

“…The present study suggested that new-generation valves are related to lower CO incidence in comparison to oldgeneration devices. New-generation valves, such as Lotus, Portico, and Evolut-R, could be easily retrieved during the procedure, 17) a function that may mitigate or recovery the CO if it happens. It is noteworthy that some new devices like Lotus were retrievable even after full implantation, while others like Portico could be retrieved only before it.…”

Section: Discussionmentioning

confidence: 99%

Incidence, Risk Factors, and Outcomes of Coronary Obstruction Following Valve-in-Valve Transcatheter Aortic Valve Replacement

et al. 2021

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There is scant information about the incidence, risk factors, and outcomes of coronary obstruction (CO) following valve-in-valve transcatheter aortic valve replacement (VIV-TAVR). A meta-analysis of the published studies from January 2000 to April 2020 was conducted, and the endpoint was CO. A total of 2858 patients were enrolled in this study. The mean age was 77.7 ± 9.8, and 39.9% of them were female. The Society of Thoracic Surgeons (STS) score, European System for Cardiac Operative Risk Evaluation (EuroSCORE), and Logistic EuroSCORE were 8.9 ± 7.8, 16.0 ± 10.9, and 26.3 ± 16.3, respectively. The overall incidence of CO was 2.58%. CO incidence between patients with prior stented and stentless valves were significantly different (1.67% versus 7.17%), with an odds ratio (OR) of 0.25 and a 95% confidence interval (CI) of 0.14-0.44 (P < 0.00001). The first-generation valves were significantly associated with higher CO incidence compared with the second-generation valves (7.09% versus 2.03%; OR, 2.44; 95%CI, 1.06-5.62; P = 0.04), while no statistical difference was found between self-expandable valves and balloon-expandable valves (2.45% versus 2.60%; OR, 0.99; 95%CI, 0.55-1.79; P = 0.98). Virtual transcatheter to coronary ostia (VTC) distance (3.3 ± 2.1 mm, n = 29 versus 5.8 ± 2.4 mm, n = 169; mean difference, −2.70; 95%CI, −3.46 to −1.95; P < 0.00001) and the sinus of Valsalva (SOV) diameter (27.5 ± 3.8 mm, n = 23 versus 32.3 ± 4.0 mm, n = 101; mean difference, −3.80; 95%CI, −6.55 to −1.05; P = 0.007) were enormously shorter in patients with CO. The 24-hour, in-hospital, and 30-day mortality of patients with CO were 10.5%, 30.8%, and 37.1%, respectively. In conclusion, device selections, VTC distances, and SOV diameters may be important factors in assessing the CO risk in VIV-TAVR.

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“…THV devices that could be immediately retrieved after partial device implantation may be the strategy of choice (e.g., Lotus, Portico, Evolut-R, etc.) to prevent such complications [107].…”

Section: Valve-in-valvementioning

confidence: 99%

Diagnostic Work-Up of the Aortic Patient: An Integrated Approach toward the Best Therapeutic Option

Pighi

Giovannini

Scarsini

et al. 2021

JCM

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Aortic stenosis (AS) is the most common valvular heart disease. In the last decade, transcatheter aortic valve implantation (TAVI) has become the standard of care for symptomatic patients at high surgical risk. Recently, indications to TAVI have also been extended to the low surgical risk and intermediate surgical risk populations. Consequently, in this setting, some aspects acquire greater relevance: surgical risk evaluation, clinical assessment, multimodality imaging of the valve, and management of coronary artery disease. Moreover, future issues such as coronary artery re-access and valve-in-valve interventions should be considered in the valve selection process. This review aims to summarize the principal aspects of a multidimensional (multidisciplinary) and comprehensive preprocedural work-up. The Heart Team is at the center of the decision-making process of the management of aortic valve disease and bears responsibility for offering each patient a tailored approach based on an individual evaluation of technical aspects together with the risks and benefits of each modality. Considering the progressive expansion in TAVI indication and technological progress, the role of a work-up and multidisciplinary Heart Team will be even more relevant.

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How to Avoid Coronary Occlusion During TAVR Valve-in-Valve Procedures

Cited by 18 publications

References 33 publications

Novel approach to stenting the left anterior descending coronary artery through a retrograde approach via the left internal mammary artery graft in a patient with occlusion of the coronary ostium from a prior aortic valve replacement

Novel approach to stenting the left anterior descending coronary artery through a retrograde approach via the left internal mammary artery graft in a patient with occlusion of the coronary ostium from a prior aortic valve replacement

Incidence, Risk Factors, and Outcomes of Coronary Obstruction Following Valve-in-Valve Transcatheter Aortic Valve Replacement

Diagnostic Work-Up of the Aortic Patient: An Integrated Approach toward the Best Therapeutic Option

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