Valvular & structural heart disease
Commissural vs Coronary Alignment to Avoid Coronary Overlap With THV-Commissure in Transcatheter Aortic Valve Replacement (TAVR): A CT-Simulation Study
Authors' conclusion
Using CT simulation, the incidence of coronary overlap with transcatheter heart valve-commissure is rare with commissural alignment. Coronary alignment reduced right coronary overlap, whereas commissural alignment had higher rates of no left coronary overlap.
Study context
- Population
- Native AS patients undergoing TAVR evaluation (April 2018 to December 2022)
- Participants
- 1,851 computed tomography (CT) scans
- Comparison
- Commissural alignment vs coronary alignment
- Outcome
- Incidence of coronary overlap with THV commissure (angular gap: severe ≤15°, moderate 15°−30°, mild 30°−45°, no-overlap 45°−60°)
Main finding
As reported in the abstract
Moderate/severe coronary overlap
Left
Right
P < 0.0001
Further findings
No left coronary overlap
P < 0.0001
Fluoroscopic angle during valve deployment, commissural vs coronary alignment
- Correlation r
- 0.80
- P
- P < 0.001
Original publication
Commissural vs Coronary Alignment to Avoid Coronary Overlap With THV-Commissure in TAVR: A CT-Simulation Study. JACC Cardiovasc Interv. Published 6 March 2024. doi:10.
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