Debate: TAVI prosthesis selection for severe calcification. The balloon-expandable technology approach

QUESTION: What are the implications of aortic valve calcification on the outcomes of transcatheter aortic valve implantation (TAVI)? ANSWER: Aortic valve calcification has, undoubtedly, been a major influence on TAVI outcomes and the evolving design of heart valves. Severe calcification has been ass...

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Main Author: Cristóbal A. Urbano-Carrillo
Format: Article
Language:English
Published: Permanyer 2025-08-01
Series:REC: Interventional Cardiology (English Ed.)
Online Access:https://recintervcardiol.org/en/index.php?option=com_content&view=article&id=2694
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author Cristóbal A. Urbano-Carrillo
author_facet Cristóbal A. Urbano-Carrillo
author_sort Cristóbal A. Urbano-Carrillo
collection DOAJ
description QUESTION: What are the implications of aortic valve calcification on the outcomes of transcatheter aortic valve implantation (TAVI)? ANSWER: Aortic valve calcification has, undoubtedly, been a major influence on TAVI outcomes and the evolving design of heart valves. Severe calcification has been associated with an increased likelihood of complications or poor outcomes, particularly in terms of residual paravalvular leak, need for postoperative pacemaker implantation, or aortic annular rupture, among others.1 Several generations of TAVI prostheses have mainly evolved with the aim of reducing paravalvular leak,2 through the use of skirts and coverings that facilitate sealing by adapting to the irregularities caused by annular and outflow tract calcifications. The goal is to balance sealing capacity with the optimal radial force needed, preventing excessive force that could cause conduction disturbances or, more critically, annular rupture. This emphasizes the critical role of procedural planning, which must account for the extent of calcification in all affected tissues. This meticulous planning, combined with experienced judgment and a deep understanding of the behaviour of each prosthesis is crucial for selecting the correct valve size. Q.: What morphological and quantitative aspects of valvular calcification do you assess at your center? A.: In addition to the usual annular measurement, in patients...
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spelling doaj-art-dd28910a98ee4f4cbda943c54a7c52c72025-08-20T03:03:15ZengPermanyerREC: Interventional Cardiology (English Ed.)2604-73222025-08-017317818010.24875/RECICE.M25000512Debate: TAVI prosthesis selection for severe calcification. The balloon-expandable technology approachCristóbal A. Urbano-Carrillo0Servicio de Cardiología, Hospital Regional Universitario de Málaga, Málaga, SpainQUESTION: What are the implications of aortic valve calcification on the outcomes of transcatheter aortic valve implantation (TAVI)? ANSWER: Aortic valve calcification has, undoubtedly, been a major influence on TAVI outcomes and the evolving design of heart valves. Severe calcification has been associated with an increased likelihood of complications or poor outcomes, particularly in terms of residual paravalvular leak, need for postoperative pacemaker implantation, or aortic annular rupture, among others.1 Several generations of TAVI prostheses have mainly evolved with the aim of reducing paravalvular leak,2 through the use of skirts and coverings that facilitate sealing by adapting to the irregularities caused by annular and outflow tract calcifications. The goal is to balance sealing capacity with the optimal radial force needed, preventing excessive force that could cause conduction disturbances or, more critically, annular rupture. This emphasizes the critical role of procedural planning, which must account for the extent of calcification in all affected tissues. This meticulous planning, combined with experienced judgment and a deep understanding of the behaviour of each prosthesis is crucial for selecting the correct valve size. Q.: What morphological and quantitative aspects of valvular calcification do you assess at your center? A.: In addition to the usual annular measurement, in patients...https://recintervcardiol.org/en/index.php?option=com_content&view=article&id=2694
spellingShingle Cristóbal A. Urbano-Carrillo
Debate: TAVI prosthesis selection for severe calcification. The balloon-expandable technology approach
REC: Interventional Cardiology (English Ed.)
title Debate: TAVI prosthesis selection for severe calcification. The balloon-expandable technology approach
title_full Debate: TAVI prosthesis selection for severe calcification. The balloon-expandable technology approach
title_fullStr Debate: TAVI prosthesis selection for severe calcification. The balloon-expandable technology approach
title_full_unstemmed Debate: TAVI prosthesis selection for severe calcification. The balloon-expandable technology approach
title_short Debate: TAVI prosthesis selection for severe calcification. The balloon-expandable technology approach
title_sort debate tavi prosthesis selection for severe calcification the balloon expandable technology approach
url https://recintervcardiol.org/en/index.php?option=com_content&view=article&id=2694
work_keys_str_mv AT cristobalaurbanocarrillo debatetaviprosthesisselectionforseverecalcificationtheballoonexpandabletechnologyapproach