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Transcatheter aortic valve-in-valve implantation (TAVI-VIV) in degenerated surgical aortic bioprosthesis is a treatment option in patients with high surgery risk. Some surgical bioprosthesis have a high-risk of coronary artery occlusion (CAO), which is one of the most dreadful complications of TAVI-VIV procedures. Two main techniques such as Bioprosthetic or native Aortic Scallop Intentional Laceration to prevent Iatrogenic Coronary Artery obstruction (BASILICA) and Shortcut (Pi-Cardia, Rehovot, Israel) are used to split the bioprosthetic leaflet to prevent CAO. In this Viewpoint we discuss the role of transesofageal echocardiography and intracardiac ultrasound in guiding and detecting complications during leaflet splitting. We also propose a classification of different scenarios regarding leaflet splitting success and coronary ostia position in relation to target bioprosthetic leaflet.
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http://dx.doi.org/10.1002/ccd.31740 | DOI Listing |
Prog Cardiovasc Dis
September 2025
Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH, USA. Electronic address:
Objectives: This study explores the impact of lower baseline aortic valve (AV) mean gradients on the clinical outcomes of patients with low-gradient aortic stenosis (LG AS) post-transcatheter aortic valve replacement (TAVR). Additionally, the study aims to understand the predictors of a lower baseline AV mean gradient (MG).
Background: Reduced left ventricular ejection fraction (LVEF) and low-flow states are known to correlate with worse clinical outcomes.
J Invasive Cardiol
September 2025
Department of Cardiology, Zhongshan Hospital, Fudan University, National Clinical Research Center for Interventional Medicine, Shanghai, China. Email:
J Invasive Cardiol
September 2025
Cardiac Surgery Unit, Mediterranea Cardiocentro, Naples, Italy.
Objectives: Failure of vascular closure device (VCD) is the most common cause of access-site vascular complications in transfemoral transcatheter aortic valve implantation (TAVI). The authors sought to determine if the systematic use of arteriotomy-site ballooning with concomitant manual compression following the delivery of a plug-based VCD (MANTA, Teleflex) can optimize toggle-plug assembly apposition to the common femoral artery (CFA) wall and improve the final hemostatic efficacy.
Methods: In this prospective, observational, single-center study, 323 consecutive patients undergoing transfemoral TAVI from October 2021 to December 2024 underwent access closure with the MANTA VCD.
J Invasive Cardiol
September 2025
Newark Beth Israel Medical Center, Newark, New Jersey.
Objectives: The authors hypothesized that the origin of the right coronary artery (RCA) is a direct continuation of the major aortic arch branches (MAAB) takeoff plane, which may have implications for brachiocephalic interventions and next generation transcatheter aortic valve intervention (TAVI) embolic protection devices (EPDs).
Methods: In this single-center, retrospective, cross-sectional study, the authors analyzed computed tomographic angiography (CTA) images from 92 patients undergoing TAVI evaluation to determine the spatial relationship between the origin of the RCA and the MAAB takeoff plane. Patients with prior cardiothoracic or aortic interventions and those with anomalous RCA origin were excluded.
Int J Surg
September 2025
Department of Cardiovascular Surgery, The Affiliated Hospital, Southwest Medical University, Metabolic Vascular Diseases Key Laboratory of Sichuan Province, Key Laboratory of Cardiovascular Remodeling and Dysfunction, Luzhou, Sichuan, PR China.
Objective: This meta-analysis aimed to compare the perioperative safety and efficacy of transcatheter aortic valve replacement (TAVR) versus surgical aortic valve replacement (SAVR) in bicuspid aortic valve (BAV) stenosis.
Methods: We systematically analyzed studies from PubMed, Cochrane Library, Embase, and CNKI comparing TAVR and SAVR in BAV stenosis. Outcomes included postoperative mortality, complications, all-cause survival, and freedom from stroke.