Real-world experience with the cusp-overlap deployment technique in transcatheter aortic valve replacement: A...

Area of Science:

• Cardiology
• Interventional Cardiology
• Medical Imaging

Background:

• Optimal implantation depth (ID) is crucial for transcatheter aortic valve replacement (TAVR) success.
• The cusp-overlap technique (COT) enhances fluoroscopic visualization for precise ID.
• This study evaluates COT's real-world performance with self-expandable TAVR prostheses.

Purpose of the Study:

• To assess the short-term clinical outcomes, safety, and efficacy of TAVR using the COT.
• To compare TAVR outcomes between the COT and conventional approaches.
• To investigate the impact of COT on implantation depth and procedural parameters.

Main Methods:

• Single-center observational study comparing 150 patients (COT) with 150 propensity score-matched patients (conventional approach).
• TAVR performed using self-expandable devices.
• Comparison of implantation depth, 30-day outcomes, fluoroscopy time, radiation dose, and length of stay.

Main Results:

• COT group showed significantly reduced mean implantation depth (p=0.007) and lower permanent pacemaker implantation rates (8.0% vs 16.8%, p=0.028).
• Fluoroscopy time decreased (p=0.023), but dose area product increased (p=0.005) in the COT group.
• Patients in the COT group experienced a shorter in-hospital stay (p=0.007).

Conclusions:

• COT in TAVR is linked to improved implantation depth and fewer conduction disturbances.
• COT use necessitates increased radiation exposure due to specific gantry angulations.
• COT demonstrates favorable short-term outcomes, including reduced length of stay and pacemaker implantation rates.