eISSN: 1897-4295
ISSN: 1734-9338
Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej
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SCImago Journal & Country Rank
2/2021
vol. 17
 
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abstract:
Image in intervention

Cusp overlap technique for transcatheter self-expanding aortic valve implantation

Jerzy Sacha
1, 2
,
Krzysztof Krawczyk
1
,
Witold Gwóźdź
3
,
Jarosław Bugajski
1
,
Mariusz Darmetko
3
,
Marek Gierlotka
1

  1. Department of Cardiology, University Hospital, Institute of Medical Sciences, University of Opole, Opole, Poland
  2. Faculty of Physical Education and Physiotherapy, Opole University of Technology, Opole, Poland
  3. Department of Cardiac Surgery, University Hospital, Institute of Medical Sciences, University of Opole, Opole, Poland
Adv Interv Cardiol 2021; 17, 2 (64): 230–231
Online publish date: 2021/07/09
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Transcatheter aortic valve implantation (TAVI) may cause atrioventricular conduction disturbances and, consequently, the necessity for permanent pacemaker implantation (PPI). This is because the His bundle surfaces at the basal part of the membranous septum (in the neighbourhood of the non-coronary cusp) and implant depth greater than the length of the membranous septum may interfere with the conduction system [1]. To mitigate this risk, the valve should be implanted at a high position to minimize the contact of the valve frame with the base of membranous septum. During TAVI, the valve is usually positioned in a coplanar fluoroscopic projection with 3 cusps view, but for a self-expanding valve, like the Evolut R (Medtronic, Minneapolis, Minnesota), such a view does not ensure a high implantation. However, a recently proposed technique based on a cusp overlap allows valve implantation at a very high position and significantly reduces the risk of PPI [2, 3].
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