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What do you think about deployment depth? Good enough or too deep. Mild PVL.

18,804 Aufrufe • vor 1 Jahr •via X (Twitter)

11 Kommentare

Profilbild von Abdel Almanfi, MD, FACC, FSCAI
Abdel Almanfi, MD, FACC, FSCAIvor 1 Jahr

Yes it’s deeper than where it should but apparently with no major consequences! Pay attention to your catheter positioning in relation to ascending aorta, try to be central (coaxial) to avoid canting. Use cusp overlap or near cusp overlap if bicuspid.

Profilbild von Dr Imran Hanif Hashmi
Dr Imran Hanif Hashmivor 1 Jahr

Thank you for your valuable comments. Recaptured twice and then deployed. Constrained even after post-dil. There was AVD. Resolved in a couple of days. PPM was not required.

Profilbild von AshishShah
AshishShahvor 1 Jahr

Valve looks slightly lower than ideal position. Was this a bicuspid AV? Do you have an orthogonal view of the valve post deployment? Thanks.

Profilbild von Dr Imran Hanif Hashmi
Dr Imran Hanif Hashmivor 1 Jahr

Not a true bicuspid but an Acquired bicuspid calcified fusion of NCC and RCC. Yes, I think the same looks slightly deep.

Profilbild von K Spargias
K Spargiasvor 1 Jahr

Not only deep but also compressed at its waist. Valvuloplasty balloon kept dog-boned and underexpanded and remaining restrained bicuspid anatomy pushed down to this positioning and valve waist compression

Profilbild von Joe Aoun
Joe Aounvor 1 Jahr

It is deep but mild PVL and no ppm, this is a win and it will help with future TAV in TAV, if needed. What balloon did you use for pre and post ballon dilation? It is interesting how the pre balloon did not expand all the way. Any gradient post implant?

Profilbild von Dr Imran Hanif Hashmi
Dr Imran Hanif Hashmivor 1 Jahr

22mm NC for predil. 25mm NC for post dil. 29mm evolut. Less than 5mm gradient postprocdure.

Profilbild von Saeed Tarabichi, MD
Saeed Tarabichi, MDvor 1 Jahr

Seems very deep especially towards the left cusp. Any pacemaker needs?

Profilbild von Dr Imran Hanif Hashmi
Dr Imran Hanif Hashmivor 1 Jahr

There was AVD post-procedure. Resolved in a couple of days. PPM was not required.

Profilbild von Ganesh Muthappan
Ganesh Muthappanvor 1 Jahr

Deep but result looks fine. If conduction system is ok then it’s a win.

Profilbild von Dr Imran Hanif Hashmi
Dr Imran Hanif Hashmivor 1 Jahr

Yes. AVD in early post-op days but resolved in a couple of days. PPM wasn't needed.

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