THV design must be improved to reduce coronary obstruction risk during TAVR-in-TAVR: Study

Washington, DC: Design improvements are needed for transcatheter heart valve (THV) as the current TAHV designs for may lead to coronary obstruction during TAVR-in-TAVR and cause problems with future coronary access, reveals a recent study. The study is published in the journal Circulation: Cardiovascular Interventions.

The tall stent frame and supra-annular leaflet position of the self-expanding Evolut PRO or Evolut PRO+ THVs may cause coronary occlusion during transcatheter aortic valve replacement (TAVR)-in-TAVR and present challenges for future coronary access. Ron Waksman, MedStar Washington Hospital Center, Washington, DC, and colleagues therefore, sought to evaluate the risk of TAVR-in-TAVR with Evolut PRO or Evolut PRO+ THVs and the feasibility of future coronary access.

The CoreValve Evolut PRO Prospective Registry prospectively enrolled eighty-one patients with symptomatic severe aortic stenosis to undergo TAVR using a commercially available latest generation self-expanding THV at 2 centers in the United States. Computed tomography was performed 30 days after TAVR, which the researchers used to simulate TAVR-in-TAVR with a second Evolut PRO or Evolut PRO+ THV and evaluate for risk of coronary obstruction and feasibility of future coronary access.