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For Small Annuli, Self-Expanding TAVR May Have an Advantage

Choice between selfexpanding balloon expandable TAVR valve multifaceted decision

During the past decade, the options for practitioners of transcatheter aortic valve replacement have expanded on a regular basis. This wave of commercially available transcatheter valves has provided clinicians with more tools in their armamentarium, allowing them to individualize the treatment of aortic stenosis to the specific patient.

Unplanned PCI Rare After TAVI, But Operators Get Good Results

Presented at: TCT 2019. September 27, 2019. Unplanned PCI following TAVI is rare, but when necessary, interventionalists are almost always able to successfully revascularize the occluded artery, according to data from an international registry. The incidence of unplanned PCI is highest in the first week after TAVI, declining over time, and the most common reason for the procedure in the first 2 years after valve implantation is acute coronary syndrome, particularly NSTEMI, according to researchers. Interestingly, the type of valve implanted had no impact on PCI outcomes, with operators reporting similar rates of successful revascularization in those treated with balloon-expandable and self-expanding bioprostheses. The self-expanding Evolut (Medtronic) valve, with its taller frame, is thought by some to make coronary reaccess more difficult when compared with other valve types.  

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