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Upper-extremity Approach for Secondary Access in Transfemoral Transcatheter Aortic Valve Implantation
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[Challenges of coronary catheterization after TAVR]
I V Simon1, F De Poli1, P Couppié1
1Service de Cardiologie, Centre Hospitalier Haguenau, 67 Avenue du Professeur René Leriche, 67500, Haguenau.
Annales De Cardiologie Et D'Angeiologie
|October 12, 2021
Summary
Coronary catheterization after transcatheter aortic valve implantation (TAVR) is feasible. While successful in all Sapien 3 patients, some challenges occurred with Evolut valves, requiring specific implantation techniques.
Area of Science:
- Cardiology
- Interventional Cardiology
- Medical Devices
Background:
- Coronary catheterization post-transcatheter aortic valve implantation (TAVR) presents unique challenges.
- Assessing the feasibility of coronary interventions after TAVR is crucial for patient management.
Purpose of the Study:
- To evaluate the feasibility of coronary catheterization and angioplasty following TAVR, comparing different valve types.
- To identify potential difficulties and success rates associated with specific TAVR devices.
Main Methods:
- Retrospective analysis of coronary angiography/angioplasty procedures in two centers after TAVR.
- Evaluation of catheterization success based on ostial engagement and artery opacification.
- Collection of procedural data including catheter types, fluoroscopy time, and contrast volume.
Main Results:
- Out of 1512 TAVR cases, 33 patients underwent coronary procedures (22 Sapien 3®, 11 Evolut®).
- Coronary angiography was successful in all Sapien 3® valve patients.
- The Evolut® group experienced 3 right and 1 left coronary non-selective catheterization events.
Conclusions:
- Coronary catheterization post-TAVR shows promising success rates, nearing 100%.
- Supra-annular Evolut® valves may present specific challenges requiring careful implantation and sinus cusp orientation.
- Standard Judkins catheters demonstrated high efficiency for both valve types.
Keywords:
TAVITAVRangioplastie coronairecathétercoronairecathétérisme coronairecoronary angioplastycoronary cathetercoronary catheterizationmicro cathetermicrocathéterremplacement aortique par voie percutanéetranscatheter aortic valve implantationMore Related Videos
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