Transcatheter aortic valve replacement with different valve types in elliptic aortic annuli

Yoshio Maeno, Yigal Abramowitz, Sung Han Yoon, Hasan Jilaihawi, Sharma Raul, Sharjeel Israr, Masaki Miyasaka, Hiroyuki Kawamori, Yoshio Kazuno, Tanya Rami, Nobuyuki Takahashi, Geeteshwar Mangat, Mohammad Kashif, Tarun Chakravarty, Mamoo Nakamura, Wen Cheng, Raj R. Makkar

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


Background: The aim of this study was to determine the influence of an elliptic annulus on acute device success rates following self-expanding (SE) transcatheter aortic valve replacement (TAVR) vs. balloon-expandable (BE) TAVR. Methods and Results: Outcomes were assessed using Valve Academic Research Consortium-2 definitions. Aortic annulus ratio (AAR) was measured as short axis diameter/long axis diameter. Mean AAR was 0.81±0.06. Patients were therefore divided into 2 groups: AAR <0.82 and AAR ≥0.82. For circular annuli (AAR ≥0.82; 363 patients), high device success rates were achieved in both valve groups (SE valve, 90.5% vs. BE valve, 95.0%, P=0.14). Conversely, for AAR <0.82 (374 patients), SE valves had lower device success rates than BE valves (82.5% vs. 95.3%, P=0.002). For elliptic annuli, SE-TAVR was an independent predictor of unsuccessful device implantation (OR, 6.34, P<0.001). Nonetheless, increased oversizing of SE valves for elliptic annuli was associated with an exponential rise in device success (threshold ≥17.5%; area under the curve, 0.83) but not for BE-TAVR. Furthermore, optimally oversized SE valves and BE valves had a similarly high device success for elliptic annuli (SE valve, 96.2% vs. BE valve, 95.3%). Conclusions: For circular annuli, similarly high device success was achieved for the 2 valve types. Conversely, for elliptic annuli, SE valves had a lower device success than BE valves. Device success following optimal oversizing of SE valves, however, was similar to that for BE valves.

Original languageEnglish
Pages (from-to)1036-1042
Number of pages7
JournalCirculation Journal
Issue number7
StatePublished - 1 Jan 2017
Externally publishedYes


  • Device success
  • Elliptic annulus
  • Transcatheter aortic valve implantation
  • Transcatheter aortic valve replacement

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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