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Transcatheter aortic valve-in-valve implantation is a validated alternative to redo surgery in patients with severe bioprosthetic valve dysfunction related to structural valve deterioration. The major life-threatening procedural complication is coronary occlusion related to the displacement of degenerated bioprosthetic leaflets, which can be avoided by using leaflet modification. The aim of this article is to present a step-by-step guide for imaging this procedure using the ShortCut device.
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http://dx.doi.org/10.1016/j.echo.2025.05.019 | DOI Listing |
JACC Case Rep
August 2025
Department of Cardiology, General Hospital of Southern Theatre Command, PLA, Guangzhou, China. Electronic address:
Background: Mirror-image dextrocardia with severe mitral regurgitation (MR) is a rare congenital anomaly that significantly increases the complexity of transcatheter mitral valve edge-to-edge repair (TEER).
Case Summary: We report the case of a 72-year-old woman with mirror-image dextrocardia and severe MR who underwent successful TEER using the MitraClip system. Because of the anatomic reversal, several procedural adaptations were required, including modified transesophageal echocardiography views, adjustments to atrial septal puncture technique, and novel strategies for delivering the clip and resolving the "aortic hug.
JTCVS Struct Endovasc
June 2025
Department of Cardiovascular Surgery, Boston Children's Hospital, Harvard Medical School, Boston, Mass.
Objective: Leaflet laceration can be an important adjunct to transcatheter aortic valve replacement to avoid coronary occlusion and to facilitate future percutaneous coronary access. The most technically challenging step is the initial leaflet traversal needed to start laceration. If traversal is achieved, then laceration is usually possible.
View Article and Find Full Text PDFJACC Case Rep
July 2025
Gagnon Cardiovascular Institute, Atlantic Health System, Morristown, New Jersey, USA.
Objectives: Coronary obstruction (CO) is a life-threatening complication of transcatheter aortic valve replacement (TAVR). Undermining iatrogenic coronary obstruction with radiofrequency needle (UNICORN) has been recently described as a novel strategy to prevent CO during TAVR. We describe here the step-by-step technique of a modified version of UNICORN.
View Article and Find Full Text PDFCirc Cardiovasc Interv
July 2025
Cardiovascular Branch, Division of Intramural Research, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD (C.G.B., R.N.H., A.E.J., R.J.L.).
Background: Coronary artery obstruction is a rare but devastating complication of transcatheter aortic valve replacement. Current techniques (transcatheter leaflet modification or snorkel stenting) cannot prevent obstruction in all cases.
Methods: We created a transcatheter coronary artery bypass procedure, VECTOR (Ventriculo-Coronary Transcatheter Outward Navigation and Re-Entry), to bypass the proximal coronary artery with a covered stent graft.
J Clin Med
July 2025
Section of Cardiology, Baylor College of Medicine, Houston, TX 77030, USA.
Aortic stenosis is the most prevalent valvular disease globally. Transcatheter aortic valve replacement (TAVR) has become a well-established treatment for aortic stenosis, offering outcomes comparable to surgical aortic valve replacement (SAVR). Its use has expanded to include younger, lower-risk patients and those with more complex anatomies.
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