Feasibility of Coronary Access Following Redo-TAVR for Evolut Failure: A Computed Tomography Simulation Study.
| Title: | Feasibility of Coronary Access Following Redo-TAVR for Evolut Failure: A Computed Tomography Simulation Study. |
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| Authors: | Tang GHL; Department of Cardiovascular Surgery, Mount Sinai Health System, New York (G.H.L.T.).; Spencer J; Structural Heart & Aortic, Medtronic, Mounds View, MN (J. Spencer, J.Z.S., G.S., J.J.P.).; Rogers T; Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington DC (T.R.).; Grubb KJ; Division of Cardiothoracic Surgery (K.J.G.), Emory University, Atlanta, GA.; Structural Heart and Valve Center (K.J.G., P.G.), Emory University, Atlanta, GA.; Gleason P; Structural Heart and Valve Center (K.J.G., P.G.), Emory University, Atlanta, GA.; Division of Cardiology (P.G.), Emory University, Atlanta, GA.; Gada H; University of Pittsburgh Medical Center Pinnacle Health, PA (H.G.).; Mahoney P; Sentara Heart Hospital, Norfolk, VA (P.M.).; Dauerman HL; University of Vermont Larner College of Medicine, Burlington (H.L.D.).; Forrest JK; Division of Cardiology, Yale School of Medicine, New Haven, CT (J.K.F.).; Reardon MJ; Department of Cardiovascular Surgery, Houston Methodist, TX (M.J.R.).; Blanke P; Center for Heart Valve Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, Canada (P.B., J.A.L.).; Leipsic JA; Center for Heart Valve Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, Canada (P.B., J.A.L.).; Abdel-Wahab M; Heart Center Leipzig at University of Leipzig, Germany (M.A.-W.).; Attizzani GF; Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, OH (G.F.A.).; Puri R; Cleveland Clinic, OH (R.P.).; Caskey M; Abrazo Arizona Heart Hospital, Phoenix (M.C.).; Chung CJ; Division of Cardiology, University of Washington Medical Center, Seattle (C.J.C.).; Chen YH; Division of Cardiology, Department of Internal Medicine, Taipei Veterans General Hospital, Taiwan (Y.-H.C.).; Dudek D; Jagiellonian University Medical College, Krakow, Poland (D.D.).; Allen KB; St. Luke's Mid America Heart Institute, Kansas City, MO (K.B.A., A.K.C.).; Chhatriwalla AK; St. Luke's Mid America Heart Institute, Kansas City, MO (K.B.A., A.K.C.).; Htun WW; Gundersen Health System, La Crosse, WI (W.W.H.).; Blackman DJ; Department of Cardiology, Leeds Teaching Hospitals, Leeds, United Kingdom (D.J.B.).; Tarantini G; Thoracic, Vascular Sciences and Public Health, University of Padua Medical School, Italy (G.T.).; Zhingre Sanchez J; Structural Heart & Aortic, Medtronic, Mounds View, MN (J. Spencer, J.Z.S., G.S., J.J.P.).; Schwartz G; Structural Heart & Aortic, Medtronic, Mounds View, MN (J. Spencer, J.Z.S., G.S., J.J.P.).; Popma JJ; Structural Heart & Aortic, Medtronic, Mounds View, MN (J. Spencer, J.Z.S., G.S., J.J.P.).; Sathananthan J; Center for Heart Valve Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, Canada (J. Sathananthan). |
| Source: | Circulation. Cardiovascular interventions [Circ Cardiovasc Interv] 2023 Nov; Vol. 16 (11), pp. e013238. Date of Electronic Publication: 2023 Nov 21. |
| Publication Type: | Journal Article; Research Support, Non-U.S. Gov't |
| Language: | English |
| Journal Info: | Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 101499602 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1941-7632 (Electronic) Linking ISSN: 19417640 NLM ISO Abbreviation: Circ Cardiovasc Interv Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: Hagerstown, MD : Lippincott Williams & Wilkins |
| MeSH Terms: | Transcatheter Aortic Valve Replacement*/adverse effects ; Aortic Valve Stenosis*/surgery ; Heart Valve Prosthesis*; Aortic Valve/diagnostic imaging ; Aortic Valve/surgery ; Humans ; Feasibility Studies ; Treatment Outcome ; Tomography, X-Ray Computed ; Prosthesis Design |
| Abstract: | Background: Coronary accessibility following redo-transcatheter aortic valve replacement (redo-TAVR) is increasingly important, particularly in younger low-risk patients. This study aimed to predict coronary accessibility after simulated Sapien-3 balloon-expandable valve implantation within an Evolut supra-annular, self-expanding valve using pre-TAVR computed tomography (CT) imaging.; Methods: A total of 219 pre-TAVR CT scans from the Evolut Low-Risk CT substudy were analyzed. Virtual Evolut and Sapien-3 valves were sized using CT-based diameters. Two initial Evolut implant depths were analyzed, 3 and 5 mm. Coronary accessibility was evaluated for 2 Sapien-3 in Evolut implant positions: Sapien-3 outflow at Evolut node 4 and Evolut node 5.; Results: With a 3-mm initial Evolut implant depth, suitable coronary access was predicted in 84% of patients with the Sapien-3 outflow at Evolut node 4, and in 31% of cases with the Sapien-3 outflow at Evolut node 5 (P |
| Competing Interests: | Disclosures Dr Tang is a physician proctor, consultant, and physician advisory board member for Medtronic, a consultant and physician advisory board member for Abbott Structural Heart, a consultant for NeoChord, and a physician advisory board member for JenaValve and Boston Scientific. He has received Speaker Honoraria for Siemens Healthineers and East End Medical. Dr Spencer is an employee and shareholder of Medtronic. Dr Rogers is a consultant and physician proctor to Edwards Lifesciences, Medtronic and Boston Scientific; is an Advisory Board member to Medtronic; has equity in Transmural Systems; and is a co-inventor on patents, assigned to National Institutes of Health, for transcatheter electrosurgery devices. Dr Grubb is a proctor, principal investigator and on the advisory board for Medtronic, serves on the advisory board or is a consultant for Ancora Heart, Boston Scientific, Abbott, 4C Medical, Gore, BioVentrix, and Edwards Lifesciences. Dr Gleason’s employer receives institutional grants and educational funding from Edwards Lifesciences, Abbott and Medtronic; he has no personal financial disclosures. Dr Gada has served as a consultant to Abbott, Bard Medical Corporation, Boston Scientific, Edwards Lifesciences, and Medtronic. Dr Mahoney is a proctor and consultant for Medtronic, Edwards, and Boston Scientific. Dr Dauerman is a consultant for Boston Scientific and Medtronic, and has received grant support from Boston Scientific and Medtronic. Dr Forrest has received grant support/research contracts and consultant fees/honoraria/speakers’ bureau fees from Edwards Lifesciences and Medtronic. Dr Reardon has received fees to his institution from Medtronic for consulting and providing educational services. Dr Blanke holds institutional research core laboratory agreements with Medtronic, Edwards Lifesciences, and Abbott with no personal compensation. Dr Leipsic holds institutional research core laboratory agreements with Medtronic, Edwards Lifesciences, Abbott, Boston Scientific, and Pi CARDIA with no personal compensation. Dr Abdel-Wahab’s institution receives speaker’s honoraria and consultancy fees on his behalf from Abbott, Boston Scientific, and Medtronic. Dr Attizzani is a consultant, serves as a proctor and is on the advisory board of Medtronic and is a consultant for Abbott Vascular. Dr Puri is a consultant, speaker and proctor for Medtronic, consults for Centerline Biomedical, Boston Scientific, Abbott, Philips, Products & Features, Shockwave Medical, VDyne, VahatiCor, Advanced Nanotherapies, NuevoSono, TherOx, GE Healthcare, BioVentrix, Protembis, and has equity interest in Centerline Biomedical, VahatiCor and NuevoSono. Dr Caskey reports proctor fees from Medtronic. Dr Chen is a proctor and is an advisory board member for Medtronic. Dr Allen has received grant support, proctor and speakers’ bureau fees from Edwards Lifesciences, Medtronic and Abbott with no personal compensation. Dr Chhatriwalla is a proctor for Edwards Lifesciences and Medtronic Inc, is on the speakers bureau for Abbott Vascular, Edwards Lifesciences and Medtronic Inc, and has a research grant from Boston Scientific. Dr Htun is a consultant for Medtronic. Dr Blackman is a proctor and consultant for Medtronic and Abbott Vascular, and a consultant for Edwards Lifesciences and Boston Scientific. Dr Tarantini has received lecture fees from Medtronic, Edwards Lifesciences, Abbott, and Boston Scientific. Dr Zhingre Sanchez is an employee and shareholder of Medtronic. Dr Popma is an employee and shareholder of Medtronic. Dr Sathananthan is a consulta nt to Edwards Lifesciences and Medtronic; and has received speaking fees from Edwards Lifesciences and NVT. The other authors report no conflicts. |
| Comments: | Comment in: Circ Cardiovasc Interv. 2023 Nov;16(11):e013572. doi: 10.1161/CIRCINTERVENTIONS.123.013572.. (PMID: 37988441) |
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| Grant Information: | UL1 TR001863 United States TR NCATS NIH HHS |
| Contributed Indexing: | Keywords: balloon-expandable valve; coronary access; implant depth; self-expanding valve; transcatheter aortic valve replacement |
| Molecular Sequence: | ClinicalTrials.gov NCT02701283 |
| Entry Date(s): | Date Created: 20231121 Date Completed: 20231127 Latest Revision: 20240329 |
| Update Code: | 20260130 |
| PubMed Central ID: | PMC10653288 |
| DOI: | 10.1161/CIRCINTERVENTIONS.123.013238 |
| PMID: | 37988439 |
| Database: | MEDLINE |
Journal Article; Research Support, Non-U.S. Gov't