{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T07:00:39Z","timestamp":1771225239706,"version":"3.50.1"},"reference-count":23,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,8,17]],"date-time":"2025-08-17T00:00:00Z","timestamp":1755388800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,8,17]],"date-time":"2025-08-17T00:00:00Z","timestamp":1755388800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Optimal projection views during transcatheter aortic valve implantation (TAVI) procedures are critical for procedural success and patient outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>This study investigated the influence of 3\u2010cusp view orientation\u2014line of alignment (LOA) versus non\u2010LOA\u2014on procedural outcomes in patients undergoing TAVI with contemporary transcatheter heart valves.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This retrospective analysis included 421 consecutive patients with severe symptomatic aortic stenosis who underwent transfemoral TAVI at a single center between March 2019 and December 2023. Patients received either SAPIEN 3 (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009140) or CoreValve Evolut R\/PRO (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009281) prostheses and were classified as having either LOA (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009312, 74.1%) or non\u2010LOA (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009109, 25.9%) projection based on pre\u2010procedural computed tomography. Primary endpoints included device success according to VARC\u20102 criteria, post\u2010procedural aortic regurgitation, and 30\u2010day clinical outcomes. Multivariate logistic regression analyses were performed to identify independent predictors of device success, post\u2010procedural hemodynamics, and the need for permanent pacemaker implantation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Non\u2010LOA patients had larger annulus dimensions (461.37\u2009\u00b1\u200983.52 vs. 441.16\u2009\u00b1\u200980.83\u2009mm\u00b2,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.03), higher calcium burden (3072.26\u2009\u00b1\u20091524.36 vs. 2646.0\u2009\u00b1\u20091189.11\u2009AU,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01), and required more contrast (179.99\u2009\u00b1\u200967.12 vs. 161.94\u2009\u00b1\u200964.7\u2009ml,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01). Multivariate analysis revealed that aortic valve calcium score was the only independent predictor of device success (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.018), while LOA orientation showed no significant association (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.971). Valve type was the primary determinant of post\u2010procedural hemodynamics (SAPIEN 3 superior,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.025), and prior bundle branch block was the strongest pacemaker predictor (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.005). Device success (94.81% vs. 95.88%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.86) and safety outcomes were comparable between groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>While LOA orientation creates anatomical differences, it doesn't change fundamental treatment decisions\u2014calcium burden and valve type remain the primary determinants of outcomes. LOA status should inform procedural planning through enhanced contrast management and risk\u2010stratified surveillance, without compromising fundamental treatment decisions. Contemporary TAVI procedures demonstrate excellent safety and efficacy across both types of projections.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ccd.70087","type":"journal-article","created":{"date-parts":[[2025,8,18]],"date-time":"2025-08-18T06:26:47Z","timestamp":1755498407000},"page":"2567-2578","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Three\u2010Cusp View Orientation in TAVI: Evaluating LOA Versus Non\u2010LOA Impact on Outcomes With Contemporary Valve Prostheses"],"prefix":"10.1002","volume":"106","author":[{"given":"Rim","family":"Kasem Ali Sliman","sequence":"first","affiliation":[{"name":"Rappaport Faculty of Medicine Technion\u2010Israel Institute of Technology Haifa 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Medicine Lady Davis Carmel Medical Center Haifa Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amir","family":"Aker","sequence":"additional","affiliation":[{"name":"Rappaport Faculty of Medicine Technion\u2010Israel Institute of Technology Haifa Israel"},{"name":"Department of Cardiovascular Medicine Lady Davis Carmel Medical Center Haifa Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hussein","family":"Sliman","sequence":"additional","affiliation":[{"name":"Rappaport Faculty of Medicine Technion\u2010Israel Institute of Technology Haifa Israel"},{"name":"Department of Cardiovascular Medicine Lady Davis Carmel Medical Center Haifa 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