TAVR isn’t just a procedure anymore — it’s a lifetime management decision.

In this in-depth case discussion, Dr. Matt Summers and Dr. Aiden Raney dive into how hemodynamics, modeling tools, and device design are reshaping how operators approach valve selection, coronary access, and reintervention planning.

Key insights include:

• Real-world cases showing how valve selection has evolved since 2018

• Using DASI modeling to predict sinus sequestration and coronary risk

• How Shortcut has simplified bilateral leaflet modification and reduced procedure times

• Lessons learned from redo-TAVR failures, pannus formation, and HALT

• Why younger and bicuspid patients still favor surgical approaches

• How commissural alignment and annular eccentricity guide modern valve choice

• When and how to tackle coronary intervention through TAVR frames

• The importance of hemodynamics over “comfort” in valve selection

This is a must-watch for interventional cardiologists aiming to merge clinical intuition with device innovation and predictive modeling for long-term outcomes.

Chapters:

00:00 – Revisiting early valve-in-valve planning

01:00 – How modeling (DOSI) predicts coronary occlusion risk 02:20 – Shortcut vs. Basilica: evolution in leaflet modification 04:00 – Purpose-built devices reducing case time and risk 05:00 – When Shortcut changes your threshold for leaflet splitting

07:00 – Lessons from redo-TAVR and pannus formation 10:00 – Why bicuspid and young patients often need surgery 13:00 – The coronary access problem that taught a hard lesson

16:00 – Commissural alignment as the key to reintervention success

18:00 – Doing left main PCI through a fresh TAVR

20:00 – Horizontal aortas and catheter flexibility

22:00 – Hemodynamics as the foundation of valve choice 24:00 – Building a lifetime valve strategy for every patient

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#TAVR #StructuralHeart #ValveInValve #LeafletModification #PredictiveModeling #CommissuralAlignment #InterventionalCardiology #DOSI #CoronaryAccess #MurmurMD