Avoiding coronary obstruction after transcatheter aortic valve replacement: Is it the skirt or what's inside that counts?

In this issue of the Journal, Chu and colleagues1 posit that coronary obstruction in patients at high risk undergoing transcatheter aortic valve replacement (TAVR) may be mitigated by the unique engagement mechanism and protective skirt of the ACURATE TA device (Symetis Inc, Ecublens, Switzerland). Initial obstacles with TAVR, including stroke, vascular complications, and paravalvular leak (PVL) have seen marked improvements through case selection and device design; however, the rare and lethal complication of coronary artery obstruction remains vexing, particularly in patients at high risk with small aortic diameters, low-lying coronary ostia, bulky leaflet calcium, and valve-in-valve procedures.
Source: The Journal of Thoracic and Cardiovascular Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Editorial commentary Source Type: research