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Related Experiment Video

Updated: Aug 2, 2025

Improved Registration of 3D CT Angiography with X-ray Fluoroscopy for Image Fusion During Transcatheter Aortic Valve Implantation
06:59

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A Simplified Fluoroscopic Method for Commissural Alignment Assessment With a Balloon-Expandable Transcatheter Heart

Mariama Akodad1,2,3,4,5, David Meier1,2,3,4, Georgios Tzimas6

  • 1Centre for Heart Valve Innovation, St Paul's and Vancouver General Hospitals, Vancouver, British Columbia, Canada.

JACC. Case Reports
|April 20, 2023
PubMed
Summary
This summary is machine-generated.

Fluoroscopy accurately assesses balloon-expandable valve commissural alignment in transcatheter aortic valve replacement. This method strongly agrees with computed tomography, offering a reliable imaging technique for procedural success.

Keywords:
aortic valvecomputed tomographyvalve replacement

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Area of Science:

  • Cardiovascular Imaging
  • Interventional Cardiology
  • Medical Device Technology

Background:

  • Transcatheter aortic valve replacement (TAVR) requires precise deployment of balloon-expandable valves.
  • Accurate commissural alignment is crucial for optimal valve function and patient outcomes.
  • Fluoroscopy is a primary imaging modality during TAVR procedures.

Observation:

  • This study evaluated the accuracy of fluoroscopy in assessing commissural alignment of balloon-expandable valves.
  • Commissural alignment was assessed using 3-cusp and cusp-overlap views on fluoroscopy in 20 patients.
  • Fluoroscopic assessments were correlated with post-TAVR computed tomography (CT) scans.

Findings:

  • There was strong agreement between fluoroscopy and CT for assessing commissural alignment (weighted Cohen's kappa coefficient: 0.88).
  • Fluoroscopic evaluation of commissural alignment is a reliable method.
  • The 3-cusp and cusp-overlap views provide accurate alignment data.

Implications:

  • Fluoroscopy can be confidently used to guide and confirm commissural alignment during TAVR.
  • This may reduce the need for post-procedural CT scans, optimizing workflow.
  • Enhanced imaging accuracy contributes to improved TAVR procedural success and patient safety.