Conversations in Interventional Cardiology: Global Results from the Optimize PRO Study: Standardized TAVR Technique and Care Pathway-Clinical Conversations in Interventional Cardiology: Global Results from the Optimize PRO Study: Standardized TAVR Technique and Care Pathway

Clinical Conversations in Interventional Cardiology: Global Results from the Optimize PRO Study: Standardized TAVR Technique and Care Pathway

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Video Summary

The discussion centers on the Global Results from the Optimized Pro-Study, evaluating the Evolute Pro and ProPlus transcatheter aortic valve replacement (TAVR) systems using the cusp overlap technique. This multicenter international study involved patients with severe aortic stenosis at intermediate risk. Key findings include that adherence to the cusp overlap technique, guided by CT angiography, achieved low 30-day all-cause mortality (<1%), low pacemaker implantation rates (~6%), and minimal paravalvular leak. Implantation depth, especially around 3mm below the non-coronary cusp, was critical for reducing conduction abnormalities. Panelists highlighted that while learning this technique can be challenging, wider adoption improves outcomes and procedural efficiency and reduces complications and hospital stays. Future considerations revolve around managing younger patients needing lifetime valve care and balancing valve positioning to optimize long-term coronary access. The use of specialized wires, like Lunderquist for larger valves, was discussed, with evolving device iterations potentially reducing the need for them. Overall, the optimized standardized pathway presents patient, provider, and health system benefits.

Keywords

Optimized Pro-Study

Evolute Pro and ProPlus

Transcatheter Aortic Valve Replacement

Cusp Overlap Technique

Aortic Stenosis Intermediate Risk