Related Experiment Video

Updated: Sep 17, 2025

Improved Registration of 3D CT Angiography with X-ray Fluoroscopy for Image Fusion During Transcatheter Aortic Valve Implantation
06:59

Improved Registration of 3D CT Angiography with X-ray Fluoroscopy for Image Fusion During Transcatheter Aortic Valve Implantation

Published on: June 3, 2018

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Multimodality Imaging for Facilitating Percutaneous Coronary Intervention of a Calcified Nodule Post Redo TAVR

Arif Al Nooryani1, Rania Taha2, George Sianos1

  • 1Cardiovascular Department, Al Qassimi Hospital, Emirates Health Services, Sharjah, United Arab Emirates.

JACC. Case Reports
|June 27, 2025
PubMed

Insights

Managing coronary artery disease after transcatheter aortic valve replacement (TAVR) is challenging. Multidetector computed tomography (MDCT) and intravascular ultrasound (IVUS) are crucial for planning percutaneous coronary intervention (PCI) in these complex cases.

Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology
  • Medical Imaging

Background:

  • Transcatheter aortic valve replacement (TAVR) is a key treatment for aortic stenosis.
  • Coronary access after repeat TAVR procedures presents significant clinical challenges.
  • The increasing use of TAVR in younger populations necessitates strategies for managing concurrent coronary artery disease.

Observation:

  • A case report details an 83-year-old woman with prior redo TAVR and recent stenting who presented with NSTEMI.
  • Imaging revealed complex coronary artery disease, including severe calcified ostial stenosis.
  • Multidetector computed tomography (MDCT) and intravascular ultrasound (IVUS) were utilized for detailed anatomical assessment.

Findings:

  • Percutaneous coronary intervention (PCI) was successfully performed to treat the severe ostial stenosis.
  • MDCT and IVUS proved invaluable in navigating the complex coronary anatomy post-TAVR.
  • The study highlights the feasibility of achieving coronary access despite previous TAVR interventions.

Implications:

  • Preprocedural imaging with MDCT and IVUS is essential for planning PCI in patients with prior TAVR.
  • These advanced imaging modalities can overcome challenges associated with coronary access in the post-TAVR setting.
  • Effective management strategies are crucial as TAVR expands to broader patient demographics.
Abstract

Keywords:
aortic valvecomputed tomographyintravascular ultrasoundpercutaneous coronary intervention

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