Page 57 - JCTR-11-4

Journal of Clinical and

Translational Research

ORIGINAL ARTICLE
Three-dimensional printing-guided coaxiality

assessment in transcatheter aortic valve
replacement for aortic regurgitation

1
Yu Mao 1 , Yang Liu 1 , Yanyan Ma , Zhenge Fan , Mengen Zhai , Yiwei Wang ,
1
1
1
3
1
2
4
5
6
Ping Jin , Yingqiang Guo , Gejun Zhang , Haibo Zhang , Lai Wei , Jian Liu ,
Fangyao Chen , Yuhui Yang , Xiangbin Pan , and Jian Yang *
7
3
1
7
1 Department of Cardiovascular Surgery, Xijing Hospital, Xi’an, Shaanxi, China
2 Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Chengdu,
Sichuan, China
3 Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese
Academy of Medical Science and Peking Union Medical College, Beijing, China
4 Department of Cardiovascular Surgery, Anzhen Hospital, Capital Medical University, Beijing, China
5 Department of Cardiovascular Surgery, Shanghai Cardiovascular Institution and Zhongshan
Hospital, Fudan University, Shanghai, China
6 Department of Cardiovascular Surgery, Guangdong Provincial People’s Hospital, Guangzhou,
Guangdong, China
7 Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University
Health Science Center, Xi’an, Shaanxi, China
*Corresponding author:
Jian Yang
(yangjian1212@hotmail.com)
Citation: Mao Y, Liu Y, Ma Y,
et al. Three-dimensional Abstract
printing-guided coaxiality
assessment in transcatheter Background: Transcatheter aortic valve replacement (TAVR) using the J-Valve system
aortic valve replacement for aortic provides a solution for patients with aortic regurgitation (AR). However, it remains
regurgitation. J Clin Transl Res.
2025;11(4):51-63. unclear whether its coaxiality performance is related to procedural complications.
doi: 10.36922/jctr.24.00084 Aim: Our goal was to improve the efficacy and accuracy of TAVR in patients
Received: December 26, 2024 with AR by adjusting J-Valve coaxiality using three-dimensional printing (3DP).
Methods: This multicenter, prospective study included 612 patients with AR who
1st revised: February 13, 2025 underwent transapical TAVR. Of these, 228 patients were assigned to the 3DP group, in
2nd revised: April 14, 2025 which the insertion angle and implantation depth were pre-determined. The coaxiality
Accepted: April 29, 2025 index was calculated using the distances from the bottom of the bioprosthesis to the
base of the three cusps. Results: Compared to the non-3DP group, the 3DP group
Published online: June 26, 2025 demonstrated better coaxiality performance (coaxiality index: 3.4 ± 1.7 vs. 4.0 ± 2.1;
Copyright: © 2025 Author(s). coaxiality angle: 10.5 ± 3.7° vs. 12 ± 4.2°; both p<0.001). Post-operative coaxiality index
This is an open-access article showed a strong correlation with the coaxiality angle (correlation coefficients: 0.85 in
distributed under the terms of the
Creative Commons AttributionNon- the 3DP group and 0.88 in the non-3DP group). The procedural success rate was higher
Commercial 4.0 International (CC in the 3DP group (100% vs. 96.4%; p=0.008). Paravalvular leakage (PVL) occurred less
BY-NC 4.0), which permits all frequently in the 3DP group (mild PVL: 3.51% vs. 18.2%; p<0.001; moderate PVL: 0%
non-commercial use, distribution,
and reproduction in any medium, vs. 1.04%; p<0.001). Multivariable analysis identified the coaxiality index, coaxiality
provided the original work is angle, and horizocardia as independent predictors of PVL. Conclusion: PVL incidence
properly cited. after TAVR can be reduced through pre-operative simulations that adjust coaxiality
Publisher’s Note: AccScience using 3DP. Relevance for patients: The high incidence of PVL in transapical TAVR
Publishing remains neutral with with the J-Valve is associated with coaxiality after bioprosthesis implantation. This
regard to jurisdictional claims in
published maps and institutional study suggests that adjusting coaxiality using pre-procedural 3DP simulations
affiliations. may effectively reduce PVL incidence and other procedural complications during

Volume 11 Issue 4 (2025) 51 doi: 10.36922/jctr.24.00084