The Official Journal of EuroPCR and the European Association of Percutaneous Coronary Interventions (EAPCI)

Interventions for valvular disease and heart failure

A novel supra-annular plane to predict TAVI prosthesis anchoring in raphe-type bicuspid aortic valve disease: the LIRA plane

EuroIntervention 2020;16:259-261. DOI: 10.4244/EIJ-D-19-00951

1. Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy; 2. Cardiac Surgery Department, San Raffaele Scientific Institute, Milan, Italy; 3. Interventional Cardiology Department, Rigshospitalet,University Hospital, Copenhagen, Denmark; 4. Interventional Cardiology Department, Heart and Vascular Center, Semmelweis University, Budapest, Hungary; 5. Department of Cardiology Department, St Thomas’ Hospital, London, United Kingdom; 6. Interventional Cardiology Unit, GVM Care & Research Maria Cecilia Hospital, Cotignola (RA), Italy; 7. Department of Cardiology, Montefiore Medical Center, New York, NY, USA; 8. Cardiovascular Research Foundation, Columbia University, New York, NY, USA


Transcatheter aortic valve implantation (TAVI) in patients with bicuspid aortic valves (BAV) may be associated with suboptimal procedural and clinical outcomes due to inappropriate prosthesis sizing, anatomical difficulties or technical factors1. The narrowest part of the aortic root in BAV anatomy is evident at the supra-annular (SA) level, across the aortic valve leaflets, instead of the annular virtual basal ring (VBR)2. The main objective of our study was to identify a supra-annular plane in the pre-TAVI cardiac computed tomography (CT) scan that might predict the level of valve prosthesis anchoring in raphe-type BAV patients.



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