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Updated: Sep 9, 2025

Upper-extremity Approach for Secondary Access in Transfemoral Transcatheter Aortic Valve Implantation
Published on: August 8, 2025
Coronary Cannulation Following Transcatheter Aortic Valve Replacement With Self-Expanding Evolut FX+ System: The
Rafey Feroze1, Marco Frazzetto1, Lakshmi Prasad Dasi2
1Division of Cardiology, Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA.
None:
•The CANNULATE TAVR II is the first prospective study evaluating coronary cannulation following implantation of the self-expanding Evolut FX+ valve, offering a direct comparison with patients treated using the previous-generation Evolut FX platform.•A novel geometric analysis using preprocedural and postprocedural computed tomography imaging was introduced to assess the spatial relationship between valve apertures and coronary ostia, incorporating the left coronary artery-right coronary artery angle and coronary height differences.•Mean time for the cannulation of the right coronary artery was faster with the newer Evolut FX+ platform compared to the previous generation, despite an experienced operator performing the procedures.•Despite approximately half of the coronaries not being within the apertures of the newer Evolut FX+ platform after post-transcatheter aortic valve replacement computed tomography-scan analysis, a successful coronary cannulation was obtained in 100% of the cases using the same approach as the prior generation, and no modifications were implemented to ensure that the apertures were co-axial with the coronaries.
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