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Related Concept Videos

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Calcium-Scoring CT ScanA calcium-scoring CT scan, also known as coronary artery calcium (CAC) scan, detects calcium deposits in the coronary arteries. This test assesses the risk of coronary artery disease (CAD), which can lead to cardiovascular events such as angina, heart failure, and sudden cardiac arrest.A calcium-scoring CT scan is generally recommended for individuals at intermediate risk of CAD without symptoms. It includes:Men aged 40-75 and women aged 50-75: Especially those with a...
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Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
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Predicting Coronary Occlusion Risk during Redo-TAVR at First TAVR: Asymmetric Calcification Causes Failure.

Kyohei Onishi1, Masakazu Yasuda2, Nobuhiro Yamada1

  • 1Division of Cardiology, Department of Medicine, Kindai University Faculty of Medicine, Osaka, Japan.

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
|February 22, 2026
PubMed
Summary
This summary is machine-generated.

Pre-procedural computed tomography (CT) accurately predicts coronary artery occlusion risk during transcatheter aortic valve (TAV) procedures, but asymmetric calcification can lead to discrepancies. Non-coronary cusp calcium volume is a key predictor of high risk during TAV-in-TAV procedures.

Keywords:
aortic stenosiscoronary obstructionsinus sequestrationtranscatheter aortic valve replacementvalve‐in‐valve

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Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Cardiac Imaging

Background:

  • Sinus sequestration (SS) risk prediction during a second transcatheter aortic valve (TAV) procedure after TAV replacement (TAVR) using pre-procedural computed tomography (CT) is underreported.
  • Accurate prediction of SS is crucial for patient safety during TAV-in-TAV procedures.

Purpose of the Study:

  • To investigate the accuracy of SS risk prediction using pre-procedural CT.
  • To compare pre-procedural CT predictions with observed SS risk on post-procedural CT during TAV-in-TAV.

Main Methods:

  • Retrospective evaluation of 139 patients undergoing TAVR with balloon-expandable valves.
  • Measurement of predicted valve-to-sinotubular junction (VTSTJ) length and coronary cusp calcium volume on pre-procedural CT.
  • Assessment of observed VTSTJ length on post-procedural CT to determine actual SS risk.

Main Results:

  • Pre-procedural CT correctly identified high SS risk in 98.7% of cases.
  • However, 72.1% of patients predicted to have low SS risk actually had high observed risk.
  • Asymmetric non-coronary cusp calcium volume (NCC-CV) ≥ 41.6% independently predicted high observed SS risk (OR: 12.59, P < 0.001).

Conclusions:

  • Pre-procedural CT is valuable for SS risk prediction but may underestimate risk in cases of asymmetric calcification.
  • Non-coronary cusp calcium volume is a critical factor to consider for accurate SS risk assessment during TAV-in-TAV.