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Objectives This study aimed to predict the displacement of self-expanding transcatheter heart valves (THV) during final deployment. Background Accurate device positioning during transcatheter aortic valve implantation (TAVI) is crucial for optimal results. Methods At our institution, 103 patients who underwent transfemoral TAVI with Evolut R were retrospectively identified. Multiple linear regression models were created, and a predictor equation was built to quantify the factors that may affect THV behavior. Results Multiple linear regression analysis for THV displacement on the left coronary cusp (LCC) identified the angle between the THV and the ascending aorta (ATA), predilation, and less operator experience as independent predictors of upward displacement, whereas estimated glomerular filtration rate (eGFR) was inversely related with THV behavior (95% confidence interval: 0.219 to 0.340, 0.447 to 2.092, 0.165 to 1.757, and -0.053 to -0.011, respectively). Predictors of THV displacement on the noncoronary cusp side could not be identified using this model. Conclusions The ATA at the point of recapture, predilation, and less operator experience were independent predictors of upward displacement of THV on the LCC side. eGFR was an independent predictor of THV downward displacement on the LCC side. Of them, the ATA was the strongest predictor. Physicians may need to adjust this angle adequately before deployment to achieve the appropriate position.

Predilatation has been historically considered a mandatory step before transcatheter aortic valve implantation (TAVI) since it facilitates valve crossing and prosthesis delivery, ensures optimal valve expansion and improves hemodynamic stability during valve deployment. However, as a result of procedural evolution over time, direct TAVI (without pre-implantation balloon aortic valvuloplasty) has emerged as an interesting option to simplify the procedure and to avoid potential valvuloplasty-related complications. Several real-world retrospective studies and one small randomised study have shown that direct TAVI (with both self-expanding and balloon-expandable prostheses) is feasible, safe and associated with outcomes similar to standard TAVI with pre-implantation balloon aortic valvuloplasty. In the absence of high-quality, robust evidence, the current review aims to discuss the advantages and disadvantages of omitting predilatation prior to TAVI.

An 87-year-old woman presented with worsening symptoms of heart failure. Echocardiography revealed paradoxical low-flow aortic stenosis (mean gradient 34 mm Hg; aortic valve area 0.9 cm2, indexed stroke volume 31 ml/m2) together with small left ventricular (LV) cavity and septal hypertrophy. The

Transcatheter aortic valve replacement (TAVR) maybe complicated by paravalvular leak (PVL). There are two TAVR valves used the most in the United States and Europe: self-expandable (SE) and balloon expandable (BE). We sought to demonstrate PVL progression based on valve type. Patients were from 3

Surgical treatment of functional mitral regurgitation (MR) is usually based on the correction of both annular dilation and leaflet disease to minimize the risk of recurrence of MR at follow-up. This combined approach may also represent an interesting strategy during transcatheter mitral valve repair systems. We report a successful case of combined Cardioband (Edwards Lifesciences, Irvine, California) and MitraClip (Abbott, Santa Clara, California) implantation for the treatment of functional MR, with good acute and medium-term clinical and echocardiographic outcomes. Le traitement chirurgical de l'insuffisance mitrale secondaire (IM) repose généralement sur la correction de la dilatation annulaire et de la maladie des feuillets pour minimiser le risque de récurrence de l'IM durant le suivi. Cette approche combinée peut également représenter une stratégie intéressante durant l'implantation par catheter de dispositifs pour la réparation de la valve mitrale. Nous rapportons le cas d'une implantation réussie de Cardioband (Edwards Lifesciences, Irvine, Californie) et de MitraClip (Abbott, Santa Clara, Californie) dans le traitement d'une IM secondaire, avec de bons résultats cliniques et échocardiographiques à court et à moyen terme.