Valvular & structural heart diseaseCohort study
Intravascular Ultrasound Assessment of Coronary Arteries at High Risk for Obstruction Following Transcatheter Aortic Valve Replacement (TAVR)
- Prospective observational study
- multicentre
Authors' conclusion
This first multicenter investigation on the IVUS use in the setting of CAO during TAVR suggests that the technique is both feasible and safe.
Study context
- Population
- Native and valve-in-valve TAVR with ≥2 radiological predefined high-risk characteristics for coronary artery obstruction
- Participants
- 32 participants · 40 vessels
- Exposure
- Intravascular ultrasound (IVUS)-guided decision on chimney stenting after TAVR
- Stentsn = 16
- Deferredn = 16reference
- Outcome
- Feasibility and safety of IVUS assessment after TAVR
Main finding
As reported in the abstract
Feasibility and safety of IVUS
Sudden coronary artery obstruction (CAO) requiring urgent chimney stenting before IVUS
2
Observational data: associations, not effects.
Secondary outcomes
Chimney stenting deferred after IVUS
- Chimney deferred
- 24 of 38 cases (63%; 95% CI: 50%-78.9%)
IVUS features guiding stenting
- Minimal cross-sectional area at the ostial-paraostial space and distance of the displaced leaflet from the coronary ostium
Safety
| Outcome | Stents | Deferred | Estimate | P value |
|---|---|---|---|---|
| MACCE · median follow-up 366 days (Q1-Q3: 119-780 days) · did not differ | Not reported in the abstract | 6.2% | (95% CI 0%–15.6%) | P = 0.958 |
- MACCE: Stented 6.2%
Original publication
Intravascular Ultrasound Assessment of Coronary Arteries at High Risk for Obstruction Following TAVR. JACC Cardiovasc Interv. Published 12 May 2025. doi:10.1016/j.jcin.2025.03.016
Summarised from the published abstract; every number is checked against it