The Official Journal of EuroPCR and the European Association of Percutaneous Coronary Interventions (EAPCI)


Contained annulus ruptures – the price to pay for optimal haemodynamic results?

EuroIntervention 2020;16:18-20. DOI: 10.4244/EIJV16I1A3

1. CardioVascular Center Zurich, Hirslanden Klinik Im Park, Zurich, Switzerland; 2. Department of Cardiology, Inselspital, University Hospital Bern, Bern, Switzerland

“You can also commit injustice by doing nothing.”

Marcus Aurelius

An 89-year-old lady is scheduled to undergo transcatheter aortic valve implantation (TAVI) with a balloon-expandable valve. Her aortic annulus is repeatedly measured at 430 mm² on a preprocedural computed tomography (CT). What valve size do you choose? What factors influence your decision? Would your choice be the same if the patient was a low-risk patient at the age of 69?

Today, a remaining challenge (or Achilles’ heel) of TAVI is the issue of sizing. Undersizing in TAVI can lead to paravalvular leaks (PVL) and ...

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