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

Interventions for valvular disease and heart failure

Hinge point-based annular plane with abnormal aortic cusps in transcatheter aortic valve replacement

EuroIntervention 2020;16:549-553. DOI: 10.4244/EIJ-D-19-00760

1. Structural and Congenital Heart Center, Hackensack University Medical Center, Hackensack, NJ, USA; 2. Philips Healthcare, Best, the Netherlands

A virtual aortic annular plane that is built using the three hinge points, known as the hinge point-based annular plane (HPAP), is routinely used during transcatheter aortic valve replacement (TAVR). Abnormal aortic cusps (AAC) with unequal length and size influence the relationship of the HPAP to the aortic root axis significantly and pose challenges to valve deployment, leading to paravalvular leak and valve embolisation. Obtaining a centreline-based aortic annular plane in addition may help to understand valve deployment behaviour in AAC better.

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