Aortic Annulus S-Curve: Implications for Transcatheter Aortic Valve Replacement and Related Procedures, Part 1

• Published in: JACC. Cardiovascular interventions Vol. 15; no. 23; pp. 2353 - 2373
• Main Authors: Zgheib, Ali, Campens, Laurence, Abualsaud, Ali, Al Isma'ili, Abdullah, Barbanti, Marco, Dvir, Danny, Gada, Hemal, Granada, Juan F, Latib, Azeem, Leipsic, Jonathon, Maisano, Francesco, Martucci, Giuseppe, Medina de Chazal, Horacio A, Modine, Thomas, Mylotte, Darren, Prendergast, Bernard, Sawaya, Fadi, Spaziano, Marco, Tang, Gilbert, Theriault-Lauzier, Pascal, Tchetche, Didier, van Mieghem, Nicolas, Søndergaard, Lars, De Backer, Ole, Piazza, Nicolo
• Format: Journal Article
• Language: English
• Published: United States 12-12-2022
• Subjects: Humans; Transcatheter Aortic Valve Replacement - adverse effects; Treatment Outcome; paravalvular leak closure; BASILICA; commissural alignment; optimal projection curves; S-curves; coronary access post-TAVR
• ISSN: 1876-7605
• DOI: 10.1016/j.jcin.2022.08.039

Most transcatheter aortic valve replacement-related procedures (eg, transcatheter aortic valve replacement implantation depth, commissural alignment, coronary access, bioprosthetic or native aortic scallop intentional laceration to prevent iatrogenic coronary artery obstruction, paravalvular leak closure) require an optimal fluoroscopic viewing angle located somewhere along the aortic annulus S-curve. Chamber views, coronary cusp and coronary anatomy, can be understood along the aortic annulus S-curve. A better understanding of the optimal fluoroscopic viewing angles along the S-curve may translate into increased operator confidence and improved safety and efficacy while reducing procedural time, radiation dose, contrast volume, and complication rates.