Mastering Short-in-Tall TAVR: Valve-in-Valve Sizing, Anchoring, and Lifetime Management with Dr. Gilbert Tang

Short-in-tall TAVR (Sapien-in-Evolut) presents unique challenges in valve sizing, anchoring, and long-term durability. In this in-depth discussion, Dr. Andrei Pop and Dr. Gilbert Tang (Mount Sinai, Structural Heart Program Director) break down their real-world approach to:Accurate CT-based sizing for valve-in-valve proceduresOversizing and volume strategies for AR vs ASAnchoring techniques to prevent delayed migrationNode 4, 5, and 6 implantation strategies and leaflet overhang concernsPre- and post-dilation pearls for safety and durabilityLifetime management, surgical considerations, and simulation insightsIf you perform valve-in-valve TAVR, this episode delivers practical pearls for safer and more durable outcomes.🔔 Subscribe for more advanced TAVR and structural heart discussions.Timestamps:00:00 – Welcome & Intro to Short-in-Tall TAVR 01:15 – Why Sapien-in-Evolut is Challenging 02:13 – CT Sizing & Oversizing for AR vs AS 06:30 – Anchoring, Gaps, and Delayed Migration Risk 09:00 – Node 4, 5, 6 Implant Strategies & Leaflet Overhang 14:45 – Predilation & Managing Hemodynamics 18:04 – Post-Dilation & Frame-to-Frame Optimization 23:15 – Bench vs In Vivo Behavior & Watermelon Seeding 30:21 – Valve Explant vs Second Valve: Lifetime Management 34:07 – Surgical Tips: Root Enlargement & Coronary Access 39:02 – DASI Simulations & Coronary Protection Pearls 40:47 – Closing Thoughts & Key Takeaways #TAVR #ValveInValve #ShortInTall #StructuralHeart #InterventionalCardiology #Sapien #Evolut #ValveDurability #CoronaryProtection #CardiologyEducation #HeartTeam #TAVRStrategy #MurmurMD