Key result
Commissural alignment during TAVI preserves coronary access, optimizes valve hemodynamics, and facilitates redo procedures.
Why the study?
Commissural alignment of the transcatheter heart valve during TAVI is seldom achieved despite its potential impact on leaflet function, coronary flow, and coronary access.
Do commissural alignment techniques improve outcomes such as coronary access and valve hemodynamics in patients undergoing transcatheter aortic valve implantation?
Do commissural alignment techniques improve outcomes such as coronary access and valve hemodynamics in patients undergoing transcatheter aortic valve implantation?
Commissural alignment during TAVI is a critical procedural step that facilitates future coronary access, improves hemodynamics, and enables redo-TAVI, requiring device-specific techniques.
May support alignment techniques in TAVI planning; leaves open prospective trials to confirm outcome benefits.
In current clinical practice, commissural alignment of the transcatheter heart valve (THV) during transcatheter aortic valve implantation (TAVI) is seldom achieved. Orientation of the THV within the aortic root and the subsequent influence upon leaflet haemodynamic function, coronary blood flow, and ease of access to the coronary ostia are gaining significant interest. Herein, we review the incidence and clinical implications of commissural misalignment in TAVI and offer thorough descriptions of how optimal alignment can be achieved with several different contemporary THV devices.
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Paredes-Vázquez et al. (2023) conducted a review in Aortic stenosis. Commissural alignment during TAVI vs. Random commissural orientation was evaluated. Commissural alignment during transcatheter aortic valve implantation facilitates future coronary access, improves valve hemodynamics, and preserves the feasibility of redo procedures.
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