Mastering Short-in-Tall TAVR: Valve-in-Valve Sizing, Anchoring, and Lifetime Management with Dr. Gilbert Tang
Description
Short-in-tall TAVR (Sapien-in-Evolut) presents unique challenges in valve sizing, anchoring, and long-term durability. In this in-depth discussion, Dr. Andrei Pop and Dr. Gilbert Tang (Mount Sinai, Structural Heart Program Director) break down their real-world approach to:
Accurate CT-based sizing for valve-in-valve procedures
Oversizing and volume strategies for AR vs AS
Anchoring techniques to prevent delayed migration
Node 4, 5, and 6 implantation strategies and leaflet overhang concerns
Pre- and post-dilation pearls for safety and durability
Lifetime management, surgical considerations, and simulation insights
If you perform valve-in-valve TAVR, this episode delivers practical pearls for safer and more durable outcomes.
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Timestamps:
00:00 – Welcome & Intro to Short-in-Tall TAVR
01:15 – Why Sapien-in-Evolut is Challenging
02:13 – CT Sizing & Oversizing for AR vs AS
06:30 – Anchoring, Gaps, and Delayed Migration Risk
09:00 – Node 4, 5, 6 Implant Strategies & Leaflet Overhang
14:45 – Predilation & Managing Hemodynamics
18:04 – Post-Dilation & Frame-to-Frame Optimization
23:15 – Bench vs In Vivo Behavior & Watermelon Seeding
30:21 – Valve Explant vs Second Valve: Lifetime Management
34:07 – Surgical Tips: Root Enlargement & Coronary Access
39:02 – DASI Simulations & Coronary Protection Pearls
40:47 – Closing Thoughts & Key Takeaways
#TAVR #ValveInValve #ShortInTall #StructuralHeart #InterventionalCardiology #Sapien #Evolut #ValveDurability #CoronaryProtection #CardiologyEducation #HeartTeam #TAVRStrategy #MurmurMD
United States
