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Published on: September 9, 2020
Leaflet modification with the ShortCut™ device to prevent coronary artery obstruction during TAVR
Dan Haberman1, Kalyan R Chitturi1, Ron Waksman1
1Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, USA.
Insights
Coronary artery obstruction (CAO) risk in transcatheter aortic valve replacement (TAVR) is reduced by the ShortCut™ device. This novel device modifies native valve leaflets, preventing CAO during TAVR, especially in valve-in-valve procedures.
Area of Science:
- Cardiovascular medicine
- Interventional cardiology
- Medical device innovation
Background:
- Transcatheter heart valve (THV) procedures, including transcatheter aortic valve replacement (TAVR), carry a risk of coronary artery obstruction (CAO).
- CAO is a serious complication, particularly in valve-in-valve (ViV) TAVR procedures, despite advances in prediction using imaging and device characteristics.
- Existing methods leave significant uncertainty in predicting and preventing CAO during TAVR.
Purpose of the Study:
- To review the ShortCut™ device, designed to prevent CAO during TAVR.
- To detail the device's design, objectives, and procedural application.
- To summarize current clinical data and future prospects for CAO prevention with the ShortCut™ device.
Main Methods:
- Review of the ShortCut™ device's design principles and intended use.
- Analysis of procedural steps for device deployment in TAVR.
- Compilation and assessment of available clinical data on the device's efficacy and safety.
Main Results:
- The ShortCut™ device aims to proactively modify native aortic valve leaflets to prevent CAO.
- The device is specifically designed for TAVR, with a focus on mitigating CAO risk in ViV TAVR.
- Early clinical data and procedural insights are presented, highlighting its potential role.
Conclusions:
- The ShortCut™ device offers a novel approach to prevent CAO in TAVR patients.
- Its specific design addresses a critical unmet need, particularly in ViV TAVR scenarios.
- Further clinical evaluation is warranted to establish its long-term impact on CAO prevention and patient outcomes.
Abstract:
Transcatheter heart valve (THV) procedures require careful planning and consideration to prevent coronary artery obstruction (CAO), which poses a significant and potentially life-threatening condition, especially in patients undergoing valve-in-valve (ViV) transcatheter aortic valve replacement (TAVR). Despite identifying predictors of CAO and utilization of computed tomography and inputting THV features, a significant uncertainty remains in predicting CAO. The ShortCut™ device (Pi-Cardia, Rehovot, Israel) was purposefully designed to modify the leaflets in patients undergoing TAVR, especially prior to ViV procedures, to overcome the risk for CAO. This review aims to detail the device's objectives, structure, procedural steps, the available clinical data, and future directions for its intended utilization in the structural arena for the prevention of CAO.
