Bailout From Sinus Jailing

Casenghi, Matteo; Oliva, O.; Squillace, Mattia; Bellamoli, Michele; Poletti, Enrico; Rubbio, Antonio Popolo; Testa, Luca; Bedogni, Francesco; Marco, Federico De

doi:10.1016/j.jaccas.2021.02.022

Cited by 7 publications

(4 citation statements)

References 3 publications

(5 reference statements)

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“…Of course, several other factors may come into play in causing bailout TAVI-in-TAVI, such as anatomic features, operator's experience, predilation, device choice, and postdilation. Accordingly, the debate can currently be epitomized as lower equals more pacemakers, and upper equals more TAVI-in-TAVI [14]. Our findings may inform decision-makers by confirming prior reports and smaller series, that operators wishing to minimize the risk of bailout TAVI-in-TAVI should pay particular attention to old patients, those with smaller body mass index, more calcific valves, larger valvular or aortic diameters, and when considering the use of self-expandable devices, in particular some of them [15].…”

Section: Discussionmentioning

confidence: 99%

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Features and outcomes of bailout repeat transcatheter aortic valve implantation (TAVI): the Bailout Acute TAVI-in-TAVI to Lessen Events (BATTLE) international registry

et al. 2023

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Aim Transcatheter aortic valve implantation (TAVI) is a mainstay in the management of severe aortic stenosis in patients with intermediate to prohibitive surgical risk. When a single TAVI device fails and cannot be retrieved, TAVI-in-TAVI must be performed acutely, but outcomes of bailout TAVI-in-TAVI have been incompletely appraised. We aimed at analyzing patient, procedural and outcome features of patients undergoing bailout TAVI-in-TAVI in a multicenter registry. Methods Details of patients undergoing bailout TAVI-in-TAVI, performed acutely or within 24 h of index TAVI, in 6 international high-volume institutions, were collected. For every case provided, 2 same-week consecutive controls (prior TAVI, and subsequent TAVI) were provided. Outcomes of interest were procedural and long-term events, including death, myocardial infarction, stroke, access site complication, major bleeding, and reintervention, and their composite (i.e. major adverse events [MAE]). Results A total of 106 patients undergoing bailout TAVI-in-TAVI were included, as well as 212 controls, for a total of 318 individuals. Bailout TAVI-in-TAVI was less common in younger patients, those with higher body mass index, or treated with Portico/Navitor or Sapien devices (all p < 0.05). Bailout TAVI-in-TAVI was associated with higher in-hospital rates of death, emergency surgery, MAE, and permanent pacemaker implantation (all p < 0.05). Long-term follow-up showed that bailout TAVI-in-TAVI was associated with higher rates of death and MAE (both < 0.05). Similar findings were obtained at adjusted analyses (all p < 0.05). However, censoring early events, outlook was not significantly different when comparing the two groups (p = 0.897 for death, and p = 0.645 for MAE). Conclusions Bail-out TAVI-in-TAVI is associated with significant early and long-term mortality and morbidity. Thus, meticulous preprocedural planning and sophisticated intraprocedural techniques are of paramount importance to avoid these emergency procedures.

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Section: Discussionmentioning

confidence: 99%

“…Of course, several other factors may come into play in causing bailout TAVI-in-TAVI, such as anatomic features, operator’s experience, predilation, device choice, and postdilation. Accordingly, the debate can currently be epitomized as lower equals more pacemakers, and upper equals more bailout TAVI-in-TAVI [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

Features and outcomes of bailout repeat transcatheter aortic valve implantation (TAVI): the Bailout Acute TAVI-in-TAVI to Lessen Events (BATTLE) international registry

et al. 2023

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“…3) A slightly deeper implantation, to reduce leaflets eversion although it may increase the risk of conduction disturbances. 35 4) Coronary protection thorough the chimney technique, as described previously. We suggest performing this technique in anatomies with highest risk of occlusion.…”

Section: Discussionmentioning

confidence: 99%

Coronary Artery anomalies in PatienTs Undergoing transcatheter aortic valve REplacement. The CAPTURE registry

Oliva,

Scalia,

Sisinni

et al. 2023

Preprint

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BackgroundThe incidence and possible implications of coronary artery anomalies (CAA) in patients undergoing transcatheter aortic valve replacement (TAVR) are uncertain.AimsTo evaluate the impact of CAA on TAVR outcomes, and to suggest possible strategies to prevent CAA related complications.MethodsAmong 2,164 consecutive patients who underwent TAVR in our center, 15 (0.69%) were identified to have a CAA, based on pre-operative Computed Tomography (CT) scans.ResultsCT-angiography revealed the following features of CAA: the majority of anomalous CAA concerned the right coronary artery (80%), followed by the left main (13.3%) and the left circumflex (6.7%). An intramural course was observed only in 26.7% patients, whereas an acute take-off was detected in more than half of the study cohort (53.3%). High-risk sudden cardiac death features were observed in 6 (40%) patients.Technical success was 86.7%, device success was 80%. One patient experienced a cardiac arrest 15 minutes after procedure, resulting from occlusion of the anomalous right coronary artery with the ostium located at the right-to-non coronary commissure. There were no cases of ≥ moderate paravalvular leak or stroke. One non-cardiac related death was recorded 4 months after the procedure.ConclusionsThe interaction between transcatheter bioprosthesis and different CAA types could lead to ominous sequelae, if not promptly recognized and treated accordingly.

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“…There are few reports of ACURATE neo THV degeneration and its management with a balloon expandable THV. 3 , 4 Mostly, a smaller THV is chosen, because nitinol frame allows enlargement. This could raise questions about final gradient, as there is a maximum diameter limitation and concerns regarding predictability of valve-to-coronary or valve-to-STJ distances, when post dilatation is needed.…”

Section: Discussionmentioning

confidence: 99%

In-Series Transcatheter Aortic Valve Replacement-in-Transcatheter Aortic Valve Replacement: ACURATE neo Transcatheter Heart Valve Degeneration Successfully Managed with Myval, Avoiding Coronary Flow Obstruction—A Case Report

Toledo¹,

Teixeirense²,

Guimaraes³

et al. 2023

Structural Heart

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Bailout From Sinus Jailing

Cited by 7 publications

References 3 publications

Features and outcomes of bailout repeat transcatheter aortic valve implantation (TAVI): the Bailout Acute TAVI-in-TAVI to Lessen Events (BATTLE) international registry

Features and outcomes of bailout repeat transcatheter aortic valve implantation (TAVI): the Bailout Acute TAVI-in-TAVI to Lessen Events (BATTLE) international registry

Coronary Artery anomalies in PatienTs Undergoing transcatheter aortic valve REplacement. The CAPTURE registry

In-Series Transcatheter Aortic Valve Replacement-in-Transcatheter Aortic Valve Replacement: ACURATE neo Transcatheter Heart Valve Degeneration Successfully Managed with Myval, Avoiding Coronary Flow Obstruction—A Case Report

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