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

18,809 次观看 • 1 年前 •via X (Twitter)

11 条评论

Abdel Almanfi, MD, FACC, FSCAI 的头像
Abdel Almanfi, MD, FACC, FSCAI1 年前

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.

Dr Imran Hanif Hashmi 的头像
Dr Imran Hanif Hashmi1 年前

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.

AshishShah 的头像
AshishShah1 年前

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

Dr Imran Hanif Hashmi 的头像
Dr Imran Hanif Hashmi1 年前

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

K Spargias 的头像
K Spargias1 年前

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

Joe Aoun 的头像
Joe Aoun1 年前

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?

Dr Imran Hanif Hashmi 的头像
Dr Imran Hanif Hashmi1 年前

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

Saeed Tarabichi, MD 的头像
Saeed Tarabichi, MD1 年前

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

Dr Imran Hanif Hashmi 的头像
Dr Imran Hanif Hashmi1 年前

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

Ganesh Muthappan 的头像
Ganesh Muthappan1 年前

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

Dr Imran Hanif Hashmi 的头像
Dr Imran Hanif Hashmi1 年前

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

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