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Unveiling Hidden Threats: Intravascular Ultrasound–Guided Precise Intervention for Coronary Ostium Obstruction Risk in Bicuspid Transcatheter Aortic Valve Replacement

Year: 2025

Type: article

Abstract: Coronary obstruction during transcatheter aortic valve replacement (TAVR) in bicuspid anatomy remains an unpredictable and potentially fatal complication. We report three representative bicuspid TAVR cases in which static computed tomography angiography (CTA) ratios-leaflet length relative to the sinotubular junction or coronary ostium-yielded conflicting or borderline risk signals. Intravascular ultrasound (IVUS) directly visualized dynamic coronary compromise and guided timely protective PCI. Each case highlights a distinct scenario: discordant metrics, borderline anatomy, and overt high-risk morphology. The combination of CTA and real-time IVUS provided decisive risk clarification and procedural safety. This case series underscores the limitations of static anatomic assessment and demonstrates the educational value of IVUS-guided decision-making in complex bicuspid TAVR.

Source: Catheterization and Cardiovascular Interventions

DOI: 10.1002/ccd.70431

Authors: Binbin Cao, Shaoyi Lin, Xiaomin Chen

Institutions: Ningbo University, Ningbo University Affiliated Hospital, Ningbo First Hospital

Language: English

Topic: Cardiac Valve Diseases and Treatments

Subfield: Cardiology and Cardiovascular Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: bronze

OpenAlex ID: W4417145136

FWCI:

Cites: 5

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