Valvular & structural heart diseaseCohort study
Predicted vs Observed Valve to Coronary Distance in Valve-in-Valve Transcatheter Aortic Valve Replacement (TAVR)
- Observational imaging study
Authors' conclusion
With nominal balloon filling, VTC and VTS distances underestimate postprocedural distances due to THV frame underexpansion. However, postdilatation may lead to distances smaller than predicted due to THV overexpansion at the outflow level.
Study context
- Population
- Patients undergoing balloon-expandable valve-in-valve TAVR
- Participants
- 51 patients
- Exposure
- Predicted vs observed valve-to-coronary and valve-to-sinus distances
- Outcome
- Agreement of predicted VTC and VTS distances with observed post-TAVR anatomy on CT, and relation to THV expansion and deployment conditions
Main finding
As reported in the abstract
Observed THV-to-coronary ostia distance minus predicted VTC distance
Nominal balloon filling
1.25
mean difference · SD 1.28 · mm
Postdilatation
−0.45
mean difference · SD 0.52 · mm
Observational data: associations, not effects.
Further findings
| Outcome | P value |
|---|---|
| THV stent frame expansion · greater expansion at all 4 THV levels | P < 0.001 |
Transcatheter heart valve (THV) stent frame expansion
- THV frame flared toward outflow but generally underexpanded at all levels, particularly at surgical heart valve (SHV) sewing ring
Original publication
Predicted vs Observed Valve to Coronary Distance in Valve-in-Valve TAVR. JACC Cardiovasc Interv. Published 19 July 2023. doi:10.1016/j.jcin.2023.05.038
Summarised from the published abstract; every number is checked against it