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Cusp overlap view improved valve positioning and significantly reduced pacemaker need, and hospital stay in TAVR with SEVs.
Researchers conducted a retrospective study published in June 2025 issue of American Journal of Cardiology to compare the cusp overlap view (COV) technique with the conventional coplanar view in transcatheter aortic valve replacement (TAVR) using self-expanding valves (SEVs), focusing on conduction outcomes and implantation characteristics.
They conducted a systematic review and meta-analysis, including 14 studies with a total of 5,266 individuals who underwent TAVR, comparing the COV with the conventional coplanar view (CPV). Data were synthesized using the DerSimonian–Laird random-effects model, and heterogeneity across studies was assessed using the I2 statistic.
The results showed that the COV technique was linked to a lower rate of permanent pacemaker implantation (PPI) at 11.2% compared to 17.7% (OR = 0.63; P< 0.0001). Individuals in the COV group had shorter hospital stays (SMD = –0.56; P= 0.016) and slightly reduced mean transvalvular gradient (SMD = –0.10; P= 0.049). Although no significant difference was observed in depth from the non-coronary cusp, the average distance from the non-coronary and left coronary cusps was lower in the COV group (SMD = –0.21; P< 0.001), suggesting a higher valve placement.
Investigators concluded that the COV technique improved clinical outcomes by lowering conduction-related complications and reducing hospital stay duration while also supporting more efficient use of healthcare resources.
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