Valvular & structural heart disease
The Coronary Access After TAVI (CAvEAT) Study: A Prospective Registry of Coronary Access (CA) After Transcatheter Aortic Valve Replacement (TAVR)
Authors' conclusion
The short-frame SAPIEN 3/Ultra THV demonstrated the highest rate of selective CA following TAVR. Among tall-frame THVs, the large-cell designs of the Portico or Navitor and ACURATE neo/neo2 outperformed the closed-cell Evolut Pro/Pro+ in terms of selective CA.
Study context
- Population
- Patients undergoing transfemoral TAVR, with coronary angiography immediately after
- Participants
- 632 patients
- Exposure
- Coronary access after TAVR across 4 THV types: short-frame SAPIEN 3/Ultra vs tall-frame ACURATE neo/neo2, Portico or Navitor, Evolut Pro/Pro+
- Outcome
- Selective coronary access of both coronary arteries
- Follow-up
- Immediately following TAVR
Methodological detailsmulticentre
- Multicentre
Main finding
As reported in the abstract
SAPIEN 3/Ultra vs all tall-frame THVs: P < 0.001 · ACURATE neo/neo2 vs Portico or Navitor: P = 0.9 · ACURATE neo/neo2 vs Evolut Pro/Pro+: P = 0.005 · Portico or Navitor vs Evolut Pro/Pro+: P = 0.002
Observational data: associations, not effects.
Further findings
Unfeasible CA of ≥1 coronary artery
- Unfeasible CA of ≥1 coronary artery: P = 0.06
Independent predictors of unfeasible or nonselective CA (multivariate)
- Implantation depth, moderate or severe commissural misalignment, and tall-frame THV
Original publication
Summarised from the published abstract; every number is checked against it