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Updated: Sep 12, 2025
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Particle Image Velocimetry Investigation of Hemodynamics via Aortic Phantom
Published on: February 25, 2022
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Differences in Coronary Alignment Between Evolut FX and Navitor Valves.
Hioki Hirofumi1, Yamamoto Masanori2,3, Ochiai Tomoki4
1Department of Cardiology, IMS Tokyo Katsushika General Hospital, Tokyo, Japan.
Summary
Supra-annular self-expandable valves (SA-SEV) show significantly lower coronary overlap after transcatheter aortic valve replacement (TAVR) compared to intra-annular self-expandable valves (IA-SEV), ensuring better future coronary access.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Medical Imaging
Background:
- Coronary access is critical for long-term patient management post-transcatheter aortic valve replacement (TAVR).
- Limited data exists on coronary alignment with current supra-annular (SA) and intra-annular (IA) self-expandable valves (SEV).
Purpose of the Study:
- To evaluate and compare coronary alignment after TAVR using SA-SEV versus IA-SEV.
- To analyze coronary overlap and ostial geometry in relation to the transcatheter heart valve (THV) frame.
Main Methods:
- Retrospective analysis of 250 SA-SEV and 152 IA-SEV TAVR cases.
- Assessment of coronary overlap (CO) via neo-commissure to coronary ostium angle.
- Evaluation of coronary geometry using vertical and horizontal distances to the THV frame.
Main Results:
- SA-SEV demonstrated significantly lower severe CO rates (LCA: 10% vs. 42%; RCA: 12% vs. 34%) compared to IA-SEV.
- Shorter vertical distance from coronary ostium to outer skirt observed with SA-SEV (LCA: 3.3mm vs. 8.0mm; RCA: 4.4mm vs. 9.0mm).
- Wider horizontal distance between coronary ostium and THV frame with SA-SEV (LCA: 4.8mm vs. 3.8mm; RCA: 5.4mm vs. 4.4mm).
Conclusions:
- Significant differences in coronary overlap and ostial geometry exist between SA-SEV and IA-SEV platforms.
- Optimizing future coronary access post-TAVR may depend on balancing anatomical factors and device-specific geometry.
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