Valvular & structural heart diseaseCohort study
Coronary Cannulation Following Transcatheter Aortic Valve Replacement (TAVR) Using Self-Expanding Devices With Commissural Alignment
- Prospective cohort study
- single-centre
- investigator-driven
- consecutive patients
Authors' conclusion
Unsuccessful coronary cannulation after TAVR using self-expanding THVs implanted using CA techniques was reported in 5.5% of cases, with the majority involving the Evolut THV. Commissural misalignment affected coronary cannulation after TAVR mostly in Evolut recipients.
Study context
- Population
- Consecutive TAVR patients receiving self-expanding transcatheter heart valves (THVs) implanted using commissural alignment, single centre, September 2021–December 2022
- Participants
- 127 patients
- Exposure
- Evolut vs ACURATE
- Outcome
- Unsuccessful coronary cannulation after TAVR
Main finding
As reported in the abstract
P = 0.26
- Overall unsuccessful coronary cannulation
- 7 (5.5%)
Observational data: associations, not effects.
Secondary outcomes
Failure of left coronary artery cannulation
P = 1.00
Failure of right coronary artery cannulation
P = 0.16
| Outcome | OR (95% CI) | P value | |
|---|---|---|---|
| Predictors of unfeasible selective coronary re-engagement on post-TAVR CT angiography — Coronary overlap vs ACURATE | 5.6 (1.2–25.8) | P = 0.03 | |
| Predictors of unfeasible selective coronary re-engagement on post-TAVR CT angiography — Severe misalignment of Evolut THVs vs ACURATE · inability to selectively cannulate both coronary arteries | 24.7 (1.9–312.9) | P = 0.01 | |
| 0.050.21520Odds ratio (log scale) |
- Predictors of unfeasible selective coronary re-engagement on post-TAVR CT angiography: inability to selectively cannulate the right coronary artery; not in ACURATE recipients (P = 0.39)
Original publication
Coronary Cannulation Following TAVR Using Self-Expanding Devices With Commissural Alignment. JACC Cardiovasc Interv. Published 6 March 2024. doi:10.1016/j.jcin.2023.12.015
Summarised from the published abstract; every number is checked against it