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The Cusp Overlap Technique Driving Consistency in Your TAVI Procedures

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Alert Indications, Safety, and Warnings

Precision

Reliable view. Accurate valve deployment.

The cusp overlap technique isolates the non-coronary cusp to provide an accurate anatomical view to assess and achieve the target implant depth.

 

Control

Valve deployment at the desired depth.

Positioning the flush port at
3 o’clock helps achieve commissural alignment that may facilitate future coronary access.1

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Chart showing the new PPI rate in seven studies over a 30-day period

Cusp Overlap Data Summary

The cusp overlap technique has been associated with single-digit pacemaker rates in several single-center and multicenter clinical studies. Large, prospective studies are being performed to confirm the risks and benefits of this new implant strategy.

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OPTIMIZE PRO STUDY

Optimize PRO study investigators use the cusp overlap technique and a prespecified conduction disturbance pathway, both of which have contributed to excellent clinical outcomes.


  8.8% 

PERMANENT PACEMAKER RATE AT 30 DAYS3


  0% 

MODERATE/SEVERE PVL AT DISCHARGE3


  0 DEATHS

AND DISABLING STROKES AT 30 DAYS3


  8.1% mm Hg

GRADIENT AT DISCHARGE

EXPERTS CORNER

TAVI implantation optimisation

Practical aspects of Cusp Overlap technique - PCR e-Course 2020

Cusp Overlap technique

How it evolved my practice - PCR London Valves 2021

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*

™ Third party brands are trademarks of their respective owners.

†

Discharge rates.

‡

53 Evolut, 3 ACURATE neo™*, 5 Portico™*.

§

Timepoint not specified.

References

1

Tang GHL, Zaid S, Fuchs A, et al. Alignment of Transcatheter Aortic-Valve Neo-Commissures (ALIGN TAVR): Impact on Final Valve Orientation and Coronary Artery Overlap. JACC Cardiovasc Interv. May 11, 2020;13(9):1030-1042.

2

Gada H, et al. Reduction of Rates of Permanent Pacemaker Implantation With 34-MM Evolut™ R Using Cusp Overlap Technique. Presented at TCT Connect 2020. 

3

Gada H, et al. Reproducibility of Cusp Overlap Technique to Reduce Permanent Pacemaker Implantation With Evolut™: The Latin American Experience. Presented at TCT Connect 2020.

4

Mendiz O, et al. Cusp Overlapping Technique for TAVR Procedures With Self-Expandable Valves. Presented at TCT Connect 2020.

5

Giuliani C, et al. Impact of Cusp-Overlap Technique on Pacemaker Requirement among Patients Receiving Transcatheter Aortic Valve Replacement. Presented at TCT Connect 2020.

6

Gada H, et al. Site-Level Variation and Predictors of Post-TAVR Permanent Pacemaker Implantation in the Evolut™ Low Risk Trial. Presented at TCT Connect 2019.

7

Pisaniello AD, et al. Implantation of Self-Expanding Transcatheter Heart Valves in the Annular Plane is Associated With Low Implant Depths and Pacemaker Rates. Presented at ACC 2020.

8

Aljabbary T, et al. Cusp Overlap Method for Self-Expanding Transcatheter Aortic Valve Replacement. Presented at CCC 2020.