{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T02:10:11Z","timestamp":1740103811152,"version":"3.37.3"},"reference-count":21,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,5,19]],"date-time":"2024-05-19T00:00:00Z","timestamp":1716076800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Transcatheter aortic valve replacement (TAVR) is increasingly being used to treat severe aortic stenosis in younger patients. Accordingly, lifetime management regarding future reintervention and coronary access is a concern.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To assess the impact of commissural alignment on ACURATE <jats:italic>neo<\/jats:italic>2 transcatheter aortic valve (TAV) performance.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>COMALIGN\u2010neo2 was an observational, retrospective study enrolling consecutive TAVR patients treated with the ACURATE <jats:italic>neo<\/jats:italic>2 (October 2021 to October 2022). The degree of commissural (mis)\u2010alignment (CMA) with the native aortic valve commissures was determined and transvalvular gradient, effective orifice area, patient\u2010prosthesis mismatch (PPM), and aortic regurgitation (AR) were assessed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 825 patients, the mean age was 80.7 years and 42% were female. Commissural alignment was achieved in 60% of cases; mild (26%), moderate (9%), and severe misalignment (5%) were found less often. Severe PPM occurred more frequently in patients with severe CMA (14.7%) compared to aligned valves (<jats:italic>p<\/jats:italic>\u2009=\u20090.034). By multivariate analysis, severe CMA (odds ratio [OR]: 3.12, 95% confidence interval [CI]\u00a0[1.09\u20138.90]; <jats:italic>p<\/jats:italic>\u2009=\u20090.033) and lack of postdilatation (OR: 3.85, [1.33\u201311.1]; <jats:italic>p<\/jats:italic>\u2009=\u20090.012) were associated with severe PPM. Higher rates of \u2265mild AR (51.4%) were found in TAVs implanted with severe CMA compared to aligned (34.3%), mildly (38.1%) or moderately (36.0%) misaligned TAVs (<jats:italic>p<\/jats:italic>\u2009=\u20090.030). Multivariate analysis identified severe CMA (OR: 2.05, [1.05\u20134.02]; <jats:italic>p<\/jats:italic>\u2009=\u20090.037) to be an independent predictor of \u2265mild AR.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>COMALIGN\u2010neo2 is the largest study to date assessing the impact of commissural alignment on acute TAV performance. Severe CMA with the ACURATE <jats:italic>neo2<\/jats:italic> platform was associated with worse valve hemodynamics and increased risk for mild AR.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.31089","type":"journal-article","created":{"date-parts":[[2024,5,20]],"date-time":"2024-05-20T06:05:50Z","timestamp":1716185150000},"page":"115-124","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Commissural\u00a0alignment and the ACURATE <i>neo2<\/i> transcatheter aortic valve: Impact on valve performance"],"prefix":"10.1002","volume":"104","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3013-2592","authenticated-orcid":false,"given":"Alejandro","family":"Travieso","sequence":"first","affiliation":[{"name":"The Heart Center Rigshospitalet Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefan","family":"Toggweiler","sequence":"additional","affiliation":[{"name":"Heart Center Lucerne Lucerner Kantonsspital Lucerne Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8496-4063","authenticated-orcid":false,"given":"Nicholas","family":"Montarello","sequence":"additional","affiliation":[{"name":"The Heart Center Rigshospitalet Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthias","family":"Renker","sequence":"additional","affiliation":[{"name":"Department of Cardiology Kerckhoff Heart Center Bad Nauheim Germany"},{"name":"Department of Cardiac Surgery Kerckhoff Heart Center Bad Nauheim Germany"},{"name":"DZHK (German Center for Cardiovascular Research) Site Rhein\u2010Main Bad Nauheim Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriela","family":"Tirado\u2010Conte","sequence":"additional","affiliation":[{"name":"The Heart Center Rigshospitalet Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lucca","family":"Loretz","sequence":"additional","affiliation":[{"name":"Heart Center Lucerne Lucerner Kantonsspital Lucerne Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Efstratios I.","family":"Charitos","sequence":"additional","affiliation":[{"name":"Department of Cardiology Kerckhoff Heart Center Bad Nauheim Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Won\u2010Keun","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Cardiology Kerckhoff Heart Center Bad Nauheim Germany"},{"name":"Department of Cardiac Surgery Kerckhoff Heart Center Bad Nauheim Germany"},{"name":"DZHK (German Center for Cardiovascular Research) Site Rhein\u2010Main Bad Nauheim Germany"},{"name":"Department of Cardiology Justus Liebig University of Giessen and Marburg Giessen Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ole","family":"De Backer","sequence":"additional","affiliation":[{"name":"The Heart Center Rigshospitalet Copenhagen 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