Lots of interesting abstracts and cases were submitted for TCTAP 2025. Below are the accepted ones after a thorough review by our official reviewers. Don’t miss the opportunity to expand your knowledge and interact with authors as well as virtual participants by sharing your opinion in the comment section!
TCTAP C-209
How TAVR Served as a Valuable Tool to the Cardio Thoracic Surgeon
By Siddharth Bajaj, Manoj Agarwala, Kiran Teja Varigonda, Leela Krishna Kaku
Presenter
Siddharth Bajaj
Authors
Siddharth Bajaj1, Manoj Agarwala1, Kiran Teja Varigonda1, Leela Krishna Kaku1
Affiliation
Apollo Hospital, India1,
View Study Report
TCTAP C-209
Structural - Aortic Valve Intervention - Minimalist TAVR
How TAVR Served as a Valuable Tool to the Cardio Thoracic Surgeon
Siddharth Bajaj1, Manoj Agarwala1, Kiran Teja Varigonda1, Leela Krishna Kaku1
Apollo Hospital, India1,
Clinical Information
Patient initials or Identifier Number
Relevant Clinical History and Physical Exam
73yrs old gentleman presented with Chest discomfort, palpitations and breathlessness. His vital parameters were stable.He had a long diastolic murmur and an ejection systolic murmur in the aortic area.His ECG revealed an LV strain pattern and echo showed severe aortic regurgitation and moderate aortic stenosis with concentric Left Ventricular Hypertrophy and good Ejection Fraction.
Relevant Test Results Prior to Catheterization
The patient was initially taken up for Surgical Aortic Valve Replacement .But after the sternotomy the surgeon realised the increased complication of surgery due to the heavily calcified Aorta with large number of plaques.Hence the procedure was abandoned the patient was referred for TAVR .A CT TAVR protocol showed calcified tricuspid aortic valve , heavily calcified ascending aorta and arch of aorta , let ventricular hypertrophy with septal bulge.
Relevant Catheterization Findings
The Annulus on CT was 20.2 mm (Small Annulus) Due to the heavy calcification Sentinel Cerebral Protection System was planned.An angiogram done showed 50% stenosis in the RCA , hence was not intervened.A pig tail catheter was used post angiogram to check gradients , the peak to peak gradient was 40 mm Hg.A pig tail angiogram revealed grade 4 AR with contrast filling the complete LV .
Interventional Management
Procedural Step
Due to the heavy calcification Sentinel Cerebral Protection System was used.Right femoral was primary Access, Left femoral vein for Temporary pacemaker , left femoral artery for pig tail insertion.
Case Summary
In a patient with heavily calcified aorta with severe Aortic regurgitation , TAVR is a valuable alternative to surgeryIn TAVR with Small Annulus , Self expanding valve a good option with good hemodynamics .Proper support of valve during valve deployment by an experienced operator is crucial TAVR with septal bulge to avoid complications.