ORIGINAL RESEARCH article
Front. Med.
Sec. Intensive Care Medicine and Anesthesiology
This article is part of the Research TopicAdvancements in Transcatheter Valve Treatment: Personalized and Precision Approaches for Minimally Invasive Interventional SurgeryView all 5 articles
The influence of different transcatheter aortic valve implantation angles, as assessed by multidetector spiral CT scanning, on the depth of valve implantation and its impact on clinical prognosis
Provisionally accepted
Shuyi Zeng
Xiangwen Liang*- Yulin First People's Hospital, Yulin, China
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Purpose: This study aimed to investigate the impact of commissural alignment on transcatheter aortic valve implantation (TAVI) depth and clinical outcomes using multidetector spiral computed tomography (MSCT) assessment. Methods: In a retrospective cohort of 215 high-surgical-risk aortic stenosis (AS) patients undergoing TAVI (April 2020–March 2024), patients were stratified into Aligned (0°–30° commissural offset, n=106) and Misaligned (>30° offset, n=109) groups based on pre/post-procedural MSCT. Primary endpoints included implantation depth, left ventricular ejection fraction [LVEF]), 30-day complications, and quality of life (Toronto Aortic Stenosis Quality of Life questionnaire [TASQ]). Results: Misaligned patients exhibited lower implantation depths at non-coronary (7.15±0.53 mm vs. 6.95±0.81 mm, p=0.035) and left coronary cusps (5.21±0.64 mm vs. 4.92±0.41 mm, p<0.001), with higher rates of deep implantation (>10 mm: 9.17% vs. 1.89%, p=0.020). Misalignment increased complications: paravalvular leakage (19.27% vs. 6.60%, p=0.006), pacemaker implantation (11.93% vs. 3.77%, p=0.027), and valve dislocation (15.60% vs. 5.66%, p=0.018). Aligned patients reported better 1-month TASQ scores (76.65±17.31 vs. 69.85±16.41, p=0.003), particularly in physical limitations (p=0.004) and emotional impact (p=0.013). Conclusion: Commissural misalignment was associated with deeper valve implantation, higher complication rates, and reduced early quality of life. Precise angular alignment could optimize TAVI outcomes, potentially by improving implantation depth consistency and reducing early adverse events. Keywords: Transcatheter Aortic Valve Implantation (TAVI); Commissural Alignment; Implantation Depth; Complications; Quality of Life.
Keywords: commissural alignment, complications, implantation depth, Quality of Life, Transcatheter aortic valve implantation (TAVI)
Received: 28 Aug 2025; Accepted: 02 Feb 2026.
Copyright: © 2026 Zeng and Liang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Xiangwen Liang
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