SAHZU President and Academician of Chinese Academy of Sciences Prof. WANG Jian'an and his team are invited to broadcast a complex transcatheter aortic valve replacement (TAVR) procedure live at the SEOUL VALVES 2025 on August 7, 2025.

The approximately 30-minute livestream meticulously showcased critical steps in TAVR procedure, including balloon pre-dilation, valve selection, aortic arch navigation, and valve deployment, and the SAHZU valve team's outstanding skills.

The demonstration highlighted the technical and strategic prowess of Chinese designed and developed medical devices and the "Hangzhou Solution", a comprehensive solution of TAVR that specifically accommodates Chinese heart valvular disease patients.

In this case, the patient is a 71-year-old male with a 3-year history of recurrent exertional dyspnea, which worsened 20 days ago. He has a medical history of end-stage renal disease and has been on long-term hemodialysis. The patient presented with physical wasting, standing 162 cm tall and weighing a mere 44 kg, resulting in a BMI of 16.7 kg/m². With an STS score of 8.259% indicating elevated surgical risk, both the cardiac surgeon and the family declined open-chest surgery after thorough consideration.

The patient's echocardiography indicated severe aortic stenosis with a peak velocity (Vmax) of 3.97 m/s, mean transvalvular pressure gradient of 41 mmHg, and aortic valve area of 0.57 cm², combined with mild mitral and tricuspid regurgitation. He's classified as IV heart failure according to NYHA functional classification.

The patient's CT measurements:

Based on the above assessment, the patient presented with a Type 0 bicuspid aortic valve complicated by ascending aortic dilation and asymmetric annular calcification. Additional anatomical complexities included a shortened aortic arch and horizontal aortic orientation, posing multiple procedural challenges such as guidewire navigation, valve positioning, and deployment angle control. Moreover, the patient's extreme physical wasting (weight: 44 kg; BMI: 16.7 kg/m²) introduced significant surgical risks, demanding exceptional precision in both systemic management and technical execution.

To address these challenges, the team implemented the "Hangzhou Solution", integrating comprehensive preoperative imaging to formulate a tailored valve selection and deployment strategy. The procedure featured:

-A parallel ICD view technique for guidewire navigation & balloon pre-dilation

-23-mm balloon pre-dilation with subsequent valve sizing per Hangzhou Solution criteria

-26-mm Prizvalve® artificial valve with controlled deployment (standard fill volume: 25 mL; adjusted per balloon response) at 90/10 depth ensuring stable anchoring

-Real-time utilization of virtual overlapping projection to overcome anatomical obstacles

During the preoceudre,  23-mm balloon predilation revealed no significant waist sign, prompting selection of a 26-mm artificial valve according to the Hangzhou Solution.

The delivery system advanced the valve smoothly across the aortic arch.

Upon reaching the annulus, precise positioning was achieved, followed by deployment of the artificial valve under rapid ventricular pacing.

Postoperative angiography confirmed optimal valve positioning with full expansion and no paravalvular leak. Postoperative echocardiography demonstrated a significant drop of mean transvalvular pressure gradient down to 7 mmHg.