TAVR Valve Choice, Coronary Access, and the Lifetime Valve Mindset: Case discussion with Dr. Summers

TAVR isn’t just a procedure anymore — it’s a lifetime management decision.

In this in-depth case discussion, Dr. Matt Summers and Dr. Aiden Raney dive into how hemodynamics, modeling tools, and device design are reshaping how operators approach valve selection, coronary access, and reintervention planning.

Key insights include:

Real-world cases showing how valve selection has evolved since 2018

Using DASI modeling to predict sinus sequestration and coronary risk

How Shortcut has simplified bilateral leaflet modification and reduced procedure times

Lessons learned from redo-TAVR failures, pannus formation, and HALT

Why younger and bicuspid patients still favor surgical approaches

How commissural alignment and annular eccentricity guide modern valve choice

When and how to tackle coronary intervention through TAVR frames

The importance of hemodynamics over “comfort” in valve selection

This is a must-watch for interventional cardiologists aiming to merge clinical intuition with device innovation and predictive modeling for long-term outcomes.

Chapters:
00:00 – Revisiting early valve-in-valve planning
01:00 – How modeling (DOSI) predicts coronary occlusion risk
02:20 – Shortcut vs. Basilica: evolution in leaflet modification
04:00 – Purpose-built devices reducing case time and risk
05:00 – When Shortcut changes your threshold for leaflet splitting
07:00 – Lessons from redo-TAVR and pannus formation
10:00 – Why bicuspid and young patients often need surgery
13:00 – The coronary access problem that taught a hard lesson
16:00 – Commissural alignment as the key to reintervention success
18:00 – Doing left main PCI through a fresh TAVR
20:00 – Horizontal aortas and catheter flexibility
22:00 – Hemodynamics as the foundation of valve choice
24:00 – Building a lifetime valve strategy for every patient

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