Coronary protection for the small left coronary sinus during transcatheter aortic valve replacement: a case report

Chen, Yang; Song, Guangyuan; Niu, Guannan; Wu, Yongjian

doi:10.1093/ehjcr/ytac011

Cited by 3 publications

(3 citation statements)

References 10 publications

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“…All patients who were enrolled with chronic severe AR in this study underwent a full-time MDCT angiography of the aortic root with a 64-slice dual-source multi-detector computed tomography (MDCT) (Somatom Definition or Somatom Force, Siemens Healthcare, Forchheim, Germany). A special software program was used for the analysis of these TAVR MDCT datasets (3mensio, Pie Medical, Maastricht, The Netherlands) [25]. MDCT measurement parameters included the number of aortic valve leaflets, annulus, left ventricular outflow tract (LVOT), sinotubular junction (STJ), ascending aorta (AA), and calcification score [26].…”

Section: Mdct Evaluation and Anatomical Classificationmentioning

confidence: 99%

Can Measuring the ‘Dual Anchors of Aorta’ Enhance the Success Rate of TAVR?—A Single-Center Experience

Chen

Ferdous

Kottu

et al. 2023

JCM

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Introduction: Chronic severe aortic regurgitation (AR) has a poor long-term prognosis, especially among old-age patients. Considering their advancing age, the surgical approach of aortic valve replacement may not always be the best alternative modality of treatment in such patients. Therefore, this study’s primary goal was to provide an initial summary of the medium- and short-term clinical effectiveness of transcatheter aortic valve replacement (TAVR) guided by accurate multi-detector computed tomography (MDCT) measurements in patients with severe and chronic AR, especially in elderly patients. Methods: The study enrolled retrospectively and prospectively patients diagnosed with severe AR who eventually underwent TAVR procedure from January 2019 to September 2022 at Fuwai cardiovascular Hospital, Beijing. Baseline information, MDCT measurements, anatomical classification, perioperative, and 1-year follow-up outcomes were collected and analyzed. Based on a novel anatomical categorization and dual anchoring theory, patients were divided into four categories according to the level of anchoring area. Type 1, 2, and 3 patients (with at least two anchoring regions) will receive TAVR with a transcatheter heart valve (THV), but Type 4 patients (with zero or one anchoring location) will be deemed unsuitable for TAVR and will instead receive medical care (retrospectively enrolled patients who already underwent TAVR are an exception). Results: The mean age of the 37 patients with severe chronic AR was 73.1 ± 8.7 years, and 23 patients (62.2%) were male. The American Association of Thoracic Surgeons’ score was 8.6 ± 2.1%. The MDCT anatomical classification included 17 cases of type 1 (45.9%), 3 cases of type 2 (8.1%), 13 cases of type 3 (35.1%), and 4 cases of Type 4 (10.8%). The VitaFlow valve (MicroPort, Shanghai, China) was implanted in 19 patients (51.3%), while the Venus A valve (Venus MedTech, Hangzhou, China) was implanted in 18 patients (48.6%). Immediate TAVR procedural and device success rates were 86.5% and 67.6%, respectively, while eight cases (21.6%) required THV-in-THV implantation, and nine cases (24.3%) required permanent pacemaker implantation. Univariate regression analysis revealed that the major factors affecting TAVR device failure were sinotubular junction diameter, THV type, and MDCT anatomical classification (p < 0.05). Compared with the baseline, the left ventricular ejection fraction gradually increased, while the left ventricular end-diastolic diameter remained small, and the N-terminal-pro hormone B-type natriuretic peptide level significantly decreased within one year. Conclusion: According to the results of our study, TAVR with a self-expanding THV is safe and feasible for patients with chronic severe AR, particularly for those who meet the criteria for the appropriate MDCT anatomical classification with intact dual aortic anchors, and it has a significant clinical effect for at least a year.

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Section: Mdct Evaluation and Anatomical Classificationmentioning

confidence: 99%

Can Measuring the ‘Dual Anchors of Aorta’ Enhance the Success Rate of TAVR?—A Single-Center Experience

Chen

Ferdous

Kottu

et al. 2023

JCM

Self Cite

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“…For example, training of ventricular septal defect repair on a silicone model of a heart is described as a useful method to improve OR planning 18 . In adult cardiac procedures, 3D‐printed models can help in planning access, for example in surgical minimally invasive aortic valve replacement 19 or to avoid complications in transcatheter aortic valve implantation 20 . The very recent trend is to integrate 3D models into virtual reality applications, as described in the paper by Kenichi and colleagues presented in this issue.…”

mentioning

confidence: 99%

“…18 In adult cardiac procedures, 3D-printed models can help in planning access, for example in surgical minimally invasive aortic valve replacement 19 or to avoid complications in transcatheter aortic valve implantation. 20 The very recent trend is to integrate 3D models into virtual reality applications, as described in the paper by Kenichi and colleagues presented in this issue. Advantages of such tools are the possibilities to interact with 3D images with little effort.…”

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confidence: 99%

Virtual reality in cardiac interventions—New tools or new toys?

Sündermann

Hennemuth

Kempfert

2022

Journal of Cardiac Surgery

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Improvementsin medical imaging and a steady increase in computing power are leading to new possibilities in the field of cardiovascular interventions. Interventions can be planned in advance in greater detail, even to the point of simulating procedures. Nevertheless, all techniques are at an early stage of development. It is of utmost importance that tools, especially if they can be used as decision support are intensively validated and their accuracy is demonstrated. In our commentary, we summarize current techniques for impprovements in planning and guiding of procedures, but also critically discuss the downsides of these techniques. Following the work of Kenichi and colleagues, we also discuss necessary steps in advancing new tools and techniques, particularly as they are used in routine clinical practice. We also discuss the role of artificial intelligence, which could play a crucial role in this context in the future.

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Computed tomography anatomical characteristics based on transcatheter aortic valve replacement in aortic regurgitation

Chen

Zhao

Liu

et al. 2023

Int J Cardiovasc Imaging

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Coronary protection for the small left coronary sinus during transcatheter aortic valve replacement: a case report

Cited by 3 publications

References 10 publications

Can Measuring the ‘Dual Anchors of Aorta’ Enhance the Success Rate of TAVR?—A Single-Center Experience

Can Measuring the ‘Dual Anchors of Aorta’ Enhance the Success Rate of TAVR?—A Single-Center Experience

Virtual reality in cardiac interventions—New tools or new toys?

Computed tomography anatomical characteristics based on transcatheter aortic valve replacement in aortic regurgitation

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