{"title":"Navitor经导管心脏瓣膜输送系统的初始方向对最终瓣膜定位和冠状动脉通路的影响。","authors":"Hirokazu Miyashita, Tomoki Ochiai, Daisuke Sato, Yoichi Sugiyama, Kunihiko Shimizu, Noriaki Moriyama, Koki Shishido, Futoshi Yamanaka, Kazuki Tobita, Takashi Matsumoto, Shingo Mizuno, Yutaka Tanaka, Masato Murakami, Shigeru Saito","doi":"10.1007/s12928-025-01158-x","DOIUrl":null,"url":null,"abstract":"<p><p>Data on the impact of the initial Navitor transcatheter heart valve (THV) deployment orientation on the final valve orientation in transcatheter aortic valve implantation (TAVI) assessed using post-implantation computed tomography (CT) is scarce. This study aimed to assess the impact of the initial deployment orientation of Navitor THV on the final orientation and neocommissural overlap with the coronary arteries. Additionally, the incidence of commissural misalignment (CMA) of Navitor THV and its impact on coronary access and short-term valve performance were evaluated. Post-TAVI CT was analysed in 77 patients. Severe coronary artery overlap with THV neocommissure was defined as 0°-20° apart. CMA was categorized by angle deviation from the native commissures: aligned (0°-15°), mild (15°-30°), moderate (30°-45°), and severe (45°-60°). The Navitor delivery system was introduced via the femoral artery with the lock button facing the 3, 6, 9, and 12 o'clock positions. Initial Navitor THV deployment orientation had no impact on the incidence of severe coronary artery overlap. Severe CMA was observed in 80.0% at 3 o'clock, 66.7% at 6 o'clock, 53.8% at 9 o'clock, and 42.2% at 12 o'clock position (p = 0.12). Severe CMA was not associated with the success rate of coronary cannulation after TAVI, short-term valve haemodynamics, or the incidence of hypoattenuated leaflet thickening. Initial Navitor THV orientation did not affect coronary artery overlap or CMA. Moreover, CMA of the Navitor THV did not affect coronary access or short-term valve performance.</p>","PeriodicalId":9439,"journal":{"name":"Cardiovascular Intervention and Therapeutics","volume":" ","pages":""},"PeriodicalIF":3.1000,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Impact of initial direction of Navitor transcatheter heart valve delivery system on final valve orientation and coronary access.\",\"authors\":\"Hirokazu Miyashita, Tomoki Ochiai, Daisuke Sato, Yoichi Sugiyama, Kunihiko Shimizu, Noriaki Moriyama, Koki Shishido, Futoshi Yamanaka, Kazuki Tobita, Takashi Matsumoto, Shingo Mizuno, Yutaka Tanaka, Masato Murakami, Shigeru Saito\",\"doi\":\"10.1007/s12928-025-01158-x\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Data on the impact of the initial Navitor transcatheter heart valve (THV) deployment orientation on the final valve orientation in transcatheter aortic valve implantation (TAVI) assessed using post-implantation computed tomography (CT) is scarce. This study aimed to assess the impact of the initial deployment orientation of Navitor THV on the final orientation and neocommissural overlap with the coronary arteries. Additionally, the incidence of commissural misalignment (CMA) of Navitor THV and its impact on coronary access and short-term valve performance were evaluated. Post-TAVI CT was analysed in 77 patients. Severe coronary artery overlap with THV neocommissure was defined as 0°-20° apart. CMA was categorized by angle deviation from the native commissures: aligned (0°-15°), mild (15°-30°), moderate (30°-45°), and severe (45°-60°). The Navitor delivery system was introduced via the femoral artery with the lock button facing the 3, 6, 9, and 12 o'clock positions. Initial Navitor THV deployment orientation had no impact on the incidence of severe coronary artery overlap. Severe CMA was observed in 80.0% at 3 o'clock, 66.7% at 6 o'clock, 53.8% at 9 o'clock, and 42.2% at 12 o'clock position (p = 0.12). Severe CMA was not associated with the success rate of coronary cannulation after TAVI, short-term valve haemodynamics, or the incidence of hypoattenuated leaflet thickening. Initial Navitor THV orientation did not affect coronary artery overlap or CMA. Moreover, CMA of the Navitor THV did not affect coronary access or short-term valve performance.</p>\",\"PeriodicalId\":9439,\"journal\":{\"name\":\"Cardiovascular Intervention and Therapeutics\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":3.1000,\"publicationDate\":\"2025-06-23\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Cardiovascular Intervention and Therapeutics\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1007/s12928-025-01158-x\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Cardiovascular Intervention and Therapeutics","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1007/s12928-025-01158-x","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
Impact of initial direction of Navitor transcatheter heart valve delivery system on final valve orientation and coronary access.
Data on the impact of the initial Navitor transcatheter heart valve (THV) deployment orientation on the final valve orientation in transcatheter aortic valve implantation (TAVI) assessed using post-implantation computed tomography (CT) is scarce. This study aimed to assess the impact of the initial deployment orientation of Navitor THV on the final orientation and neocommissural overlap with the coronary arteries. Additionally, the incidence of commissural misalignment (CMA) of Navitor THV and its impact on coronary access and short-term valve performance were evaluated. Post-TAVI CT was analysed in 77 patients. Severe coronary artery overlap with THV neocommissure was defined as 0°-20° apart. CMA was categorized by angle deviation from the native commissures: aligned (0°-15°), mild (15°-30°), moderate (30°-45°), and severe (45°-60°). The Navitor delivery system was introduced via the femoral artery with the lock button facing the 3, 6, 9, and 12 o'clock positions. Initial Navitor THV deployment orientation had no impact on the incidence of severe coronary artery overlap. Severe CMA was observed in 80.0% at 3 o'clock, 66.7% at 6 o'clock, 53.8% at 9 o'clock, and 42.2% at 12 o'clock position (p = 0.12). Severe CMA was not associated with the success rate of coronary cannulation after TAVI, short-term valve haemodynamics, or the incidence of hypoattenuated leaflet thickening. Initial Navitor THV orientation did not affect coronary artery overlap or CMA. Moreover, CMA of the Navitor THV did not affect coronary access or short-term valve performance.
期刊介绍:
Cardiovascular Intervention and Therapeutics (CVIT) is an international journal covering the field of cardiovascular disease and includes cardiac (coronary and noncoronary) and peripheral interventions and therapeutics. Articles are subject to peer review and complete editorial evaluation prior to any decision regarding acceptability. CVIT is an official journal of The Japanese Association of Cardiovascular Intervention and Therapeutics.