Document Type
Article
Publication Date
2026
DOI
10.1016/j.jaccas.2026.109569
Publication Title
JACC: Case Reports
Volume
31
Issue
36
Pages
109569 (3 pp.)
Abstract
Image(s)
Computed tomography (CT) and computational modeling (DASI) in redo transcatheter aortic valve replacement (TAVR) planning.
Case Summary
A 77-year-old woman presented with severe symptomatic aortic stenosis due to degeneration of a prior transcatheter valve. CT demonstrated leaflet calcification with borderline left-sided valve-to-coronary distance (3.27 mm). Geometric assessment suggested low right coronary obstruction risk, but higher left main risk. Computational modeling demonstrated adequate leaflet-coronary clearance (distance from displaced leaflet cusp to coronary ostium normalized to coronary diameter >0.7). Redo TAVR with a 26-mm Evolut FX was performed without leaflet modification and no coronary obstruction.
Take-Home Message
Borderline CT findings in redo TAVR require coronary-specific interpretation; computational modeling may provide reassurance when avoiding leaflet modification.
Rights
© 2026 The Authors.
This is an open access article under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) License.
Original Publication Citation
McKechnie, C. J., Valle, N. J., Saleh, O. A., Summers, M. R., & Talreja, D. R. (2026). Redo TAVR with asymmetric coronary risk: Interpreting borderline CT findings. JACC: Case Reports, 31(36), Article 109569. https://doi.org/10.1016/j.jaccas.2026.109569
Repository Citation
McKechnie, C. J., Valle, N. J., Saleh, O. A., Summers, M. R., & Talreja, D. R. (2026). Redo TAVR with asymmetric coronary risk: Interpreting borderline CT findings. JACC: Case Reports, 31(36), Article 109569. https://doi.org/10.1016/j.jaccas.2026.109569
Supplemental Appendix
Included in
Cardiovascular System Commons, Investigative Techniques Commons, Surgical Procedures, Operative Commons