The anatomic interplay between aortic valve, ascending aorta, left ventricular outflow tract and peripheral vasculature play a major role in determining device related outcomes in transcatheter aortic valve replacement. Factors such as the alignment angle (prosthesis-ascending aorta), pre-dilatation, operating team experience and chronic kidney disease may play a role in valve displacement. Careful analysis of all imaging modalities while sizing and selecting a valve type, and attention to newer deployment techniques may improve outcomes.
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