According to a new study, a new approach to self-expanding transcatheter aortic valve replacement could minimize the risk of permanent pacemaker implantation.
The patient-specific approach was used in analyzing nearly 250 patients with severe aortic stenosis who underwent TAVR to look at factors contributing to PPMI, according to Medscape. The study was published by lead author Dr. Hasan Jilaihawi of NYU Langone Health in the August 26 online edition of the JACC: Cardiovascular Interventions.
The minimizing-depth-according-to-the-membranous-septum approach was created for device implantation and the analysis found that implant depth greater than the length of the membranous septum independently predicted PPMI.
The MIDAS approach was delivered to 100 patients with the device placed at a depth lesser than the MS length and the PPMI rate dropped from 9.7% to 3%. The rate of left bundle branch block was also slashed from 25.8% in the original group to 9% in the MIDAS group.
“In a nutshell, to summarize the rationale, rather than doing the procedure the same way for every patient, we tailored the positioning of the valve according to the individual patient’s anatomy of the MS,” Jilaihawi told theheart.org/Medscape Cardiology. “In our center, using this approach, we have been able to reduce our CoreValve pacemaker rates to lower than the rates of surgical aortic valve replacement.”
In August, the FDA expanded the approval for TAVR valves for low-risk patients made by Medtronic (NYSE:MDT) and Edwards Lifesciences (NYSE:EW). In June, The Centers for Medicare and Medicaid Services updated the criteria for hospitals and physicians to begin or continue providing TAVR surgery. The decision gives hospitals and providers more flexibility to meet the CMS requirements for performing TAVR, according to the agency.