Key result
Commissural alignment during TAVR facilitates coronary access and may improve valve hemodynamics and durability.
Why the study?
As TAVR indications expand to younger and lower-risk patients, commissural alignment is a procedural goal to facilitate coronary access for long-term coronary artery disease management and potentially improve valve hemodynamics and durability.
Achieving commissural alignment during TAVR is a key procedural goal to facilitate future coronary access and potentially improve valve hemodynamics and durability.
Supports commissural alignment in TAVR planning for easier coronary access; leaves open prospective validation of durability benefits.
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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Quagliana et al. (2023) conducted a review in Severe symptomatic aortic stenosis. Commissural alignment techniques during TAVR was evaluated. Achieving commissural alignment during transcatheter aortic valve replacement facilitates future coronary access and may positively impact transvalvular hemodynamics and valve durability.
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