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Related Experiment Video

Updated: Jan 16, 2026

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

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Fluoroscopic "Lucent Line" Visualization in SAPIEN 3 TAVR Deployment: Reproducibility and Impacts on Outcomes.

Parasuram Krishnamoorthy1, Manish Vinayak1, Negar Salehi1

  • 1Division of Cardiology, Mount Sinai Hospital, New York, New York.

Journal of the Society for Cardiovascular Angiography & Interventions
|October 3, 2025
PubMed
Summary
This summary is machine-generated.

Fluoroscopic radiolucent line (LL) visualization during SAPIEN 3 (S3) transcatheter aortic valve replacement (TAVR) is not always reproducible and does not guarantee optimal valve implantation or improved outcomes. No significant short-term clinical impact was observed.

Keywords:
coaxialitylucent linetranscatheter aortic valve replacement

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Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology
  • Medical Imaging

Background:

  • Fluoroscopic radiolucent line (LL) visualization is proposed for optimizing SAPIEN 3 (S3) transcatheter aortic valve replacement (TAVR) implant depth.
  • However, the reproducibility and clinical outcomes associated with LL visualization remain largely unknown.

Purpose of the Study:

  • To determine the incidence of LL visualization at the conventional deployment view during S3 TAVR.
  • To evaluate the association between LL visualization and procedural outcomes.

Main Methods:

  • Retrospective analysis of fluoroscopic images from 1130 consecutive transfemoral S3 TAVR procedures (April 2017 - September 2022).
  • Evaluation of LL presence and S3 valve coaxiality at final implantation using the 3-cusp coplanar view.
  • Assessment of procedural and in-hospital outcomes according to Valve Academic Research Consortium 3 definitions.

Main Results:

  • LL was visualized in only 64.8% of cases, and coaxial implantation was achieved in 45.6%.
  • Three deployment scenarios were identified: LL+/Coaxial (44.5%), LL+/Non-coaxial (20.3%), and LL-/Non-coaxial (34.2%).
  • LL visualization was associated with deeper S3 implantation, but no significant differences in paravalvular leak, pacemaker implantation, or hemodynamic performance were observed across the scenarios.

Conclusions:

  • LL visualization in S3 TAVR is not consistently achievable and does not reliably lead to coaxial deployment or improved implantation depth.
  • Despite these limitations, no short-term clinical or echocardiographic adverse effects were noted.