Transcatheter aortic valve implantation (TAVR) is the first therapeutic option for elderly patients with severe symptomatic aortic stenosis, and indications are steadily expanding to younger patients and subjects with lower surgical risk and longer life expectancy. Commissural alignment between native and transcatheter valves facilitates coronary access after TAVR and is thus considered a procedural goal, allowing long-term management of coronary artery disease. Moreover, commissural alignment may potentially have a positive impact on transvalvular hemodynamic and valve durability. This review focus on technical hints to achieve commissural alignment and current evidence for different transcatheter aortic valves.
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| http://dx.doi.org/10.3390/jcm12062136 | DOI Listing |
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Article Synopsis
- The study aimed to assess the hemodynamic effects of commissural alignment (CA) in patients receiving self-expandable transcatheter aortic valves (TAVR) using two different devices: Evolut Pro (EP) and Acurate neo2 (AN2).
- Analyzing 557 patients, the results showed that CA was linked to a significant reduction in the rate of commissural misalignment (CMA) compared to those without CA, leading to lower transvalvular gradients and less aortic regurgitation after one year.
- Although patients with moderate/severe CMA experienced worsened aortic gradients and regurgitation rates, overall structural deterioration criteria were not met at
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