title: C-THV measures of self-expandable valve positioning and correlation with implant outcomes.
abstract: BACKGROUND
  Accurate positioning of the valve device during transcutaneous aortic valve implantation (TAVI) is of crucial importance. The Paieon C-THV navigation system has been designed to correctly guide device deployment during TAVI.
  
  
  OBJECTIVE
  Using this navigation system we aimed to determine the correlation between the anatomic measures of the native aortic valve and the deployed self-expandable valve positioning and to explore the impact upon procedural outcomes.
  
  
  METHODS
  We analyzed data of 68 patients with severe symptomatic aortic stenosis undergoing TAVI, using the catheter-based Medtronic-CoreValve self-expandable system. Patients were subdivided into two groups according to whether the C-THV system was used (50) or not (18) during the implantation process. Analysis of geometrical outcomes vs. clinical outcomes including postprocedural electrical conduction defect and/or para-valvular leaks was performed.
  
  
  RESULTS
  Taking the target implantation line as a reference; relatively lower vs. higher implantations correlated with a higher frequency of any new onset electrical conduction defect (ECD). The mean corresponding distance from valve inferior edge below the virtual aortic annulus line was 3.0 ± 1.6 mm vs. 1.2 ± 1.3 mm in patients with (38.5%) vs. without any new onset ECD, respectively (P = 0.05). The use of C-THV navigation seemed to correlate with higher valve implants but it had no impact on the occurrence of postprocedural paravalvular leaks.
  
  
  CONCLUSIONS
  Self-expandable valve implants guided by C-THV navigation seems to be associated with more precise implants and lower risk for postprocedural electrical conduction defects, due to higher location in relation to the target line.
authors.affiliation: Interventional Cardiology Department, Beillinson Hospital, Rabin Medical Center and the "Sackler", Faculty of Medicine Tel-Aviv University, Israel.
authors.forename: Pablo
authors.initials: P
authors.lastname: Codner
authors.forename: Ifat
authors.initials: I
authors.lastname: Lavi
authors.forename: Guy
authors.initials: G
authors.lastname: Malki
authors.forename: Hana
authors.initials: H
authors.lastname: Vaknin-Assa
authors.forename: Abid
authors.initials: A
authors.lastname: Assali
authors.forename: Ran
authors.initials: R
authors.lastname: Kornowski
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000503:physiopathology; D001024:Aortic Valve Stenosis / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D006328:Cardiac Catheterization / Q000009:adverse effects / Q000295:instrumentation*; D005260:Female; D006327:Heart Block / Q000209:etiology; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D007557:Israel; D008297:Male; D011474:Prosthesis Design; D015641:Radiography, Interventional; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D016896:Treatment Outcome
keywords: TAVI; aortic stenosis; self-expandable valve; transcutaneous aortic valve implantation