Cusp Overlap Technique: Should It Become the Standard Implantation Technique for Self-expanding Valves?
Aditya SenguptaSophia L AlexisTimothy LeeSyed ZaidParasuram M KrishnamoorthySahil KheraStamatios LerakisMalcolm AnastasiusGeorge D DangasSamin K SharmaAnnapoorna S KiniGilbert H L TangPublished in: Current cardiology reports (2021)
The use of the cusp-overlap view with the Evolut, Portico, ACURATE neo/neo2, and JenaValve systems is associated with lower post-procedural new permanent pacemaker implantation rates when compared with the standard 3-cusp view, presumably due to more precise valve implantation relative to the conduction system by the non-coronary cusp. By elongating the left ventricular outflow tract and accentuating the right-non commissure in the center of the fluoroscopic view, the cusp-overlap technique allows operators to more precisely control the prosthesis implant depth during self-expanding valve deployment. While the early experience with this approach in Evolut TAVR has been promising, the results of larger studies with longer follow-up across multiple self-expanding systems are warranted.
Keyphrases
- aortic stenosis
- aortic valve
- transcatheter aortic valve implantation
- aortic valve replacement
- left ventricular
- transcatheter aortic valve replacement
- ejection fraction
- mitral valve
- coronary artery disease
- heart failure
- coronary artery
- hypertrophic cardiomyopathy
- optical coherence tomography
- case control
- vena cava
- pulmonary embolism
- cardiac resynchronization therapy
- inferior vena cava