Aortic Valve Hemodynamic Physiology: New Insights to Improve Patient Selection.

A Cureus meta-analysis of 4,828 patients (four studies, all non-randomized) found Abbott's Navitor self-expandable valve tripled moderate-to-severe PVL versus SAPIEN (RR 3.36) and doubled permanent pacemaker rates (RR 2.16), while cutting patient-prosthesis mismatch nearly in half (RR 0.55) — a hemodynamic-versus-complication tradeoff the guidelines don't yet address.

And a JACC CV Interv position statement formalized the "TAVR CODE" framework (coaxiality, orientation, depth, expansion) to standardize implantation and preserve future valve-in-valve options — directly relevant to the ESC 2025 lifetime management push for patients ≥70.

Surgical counterpoint: ACC/AHA 2020 still favors SAVR for patients Additional items: sublingual nitroglycerin before pre-TAVI CCTA (single-center prospective, N=109) improved diagnostic accuracy from 67.6% to 84.9% and cut equivocal CAD-RADS 3 scans, challenging a long-standing SCCT contraindication.