Page 67 - JCTR-11-4

Journal of Clinical and
Translational Research AR-TAVR coaxiality assessment using 3DP

factors, resulting in a larger diameter profile in the planned 5. Conclusion
anchoring area, and deviations between the measured and
calculated diameters and the actual implanted valve size. In this prospective, observational, multicenter study, the
29
In addition, there remains an insufficient understanding results show that transapical TAVR using the J-Valve
is feasible for patients with pure AR, with encouraging
of the impact of radial expansion with prosthetic sizing short- and midterm clinical outcomes. Importantly, the
selection, making it difficult to achieve optimal therapeutic higher incidence of PVL and other procedural complications
effects after implantation. 29
after implantation appears to be mitigated by pre-operative
It is worth noting that THV coaxiality has a significant simulations based on the 3DP model. The occurrence of PVL
influence on the occurrence of procedural complications is greatly reduced by evaluating the coaxiality index to achieve
in TAVR. Pre-operative CTA or transthoracic the desired position. Long-term follow-up of a larger number
30
echocardiography is typically required to assess the of patients is needed to more fully assess the effectiveness and
morphology and size of the aortic root to guide THV durability of J-Valve implants in patients with AR.
implantation planning and prosthesis size selection.
However, unlike in SAVR, surgeons performing TAVR Acknowledgments
must rely solely on imaging as the procedure is conducted We would like to thank Make Medical Technology Co.,
without direct surgical visualization. The advent of LTD (China) for supplying the three-dimensional-printed
cardiovascular 3DP offers an innovative solution to this models and Protext Editorial Services (USA) for English
challenge. Previous studies have confirmed that pre- language editing.
procedural planning enabled by 3DP may significantly
improve anatomical visualization, provide more accurate Funding
THV sizing recommendations, and help determine the This work was supported by the Development and
optimal THV implantation position while identifying Transformation of New Technology and Construction
potential complications through pre-procedural of Precision Diagnosis and Treatment System for
simulations. 31,32 Our preliminary data support these Transcatheter Interventional Diagnosis and Treatment of
findings. The current outcome analysis showed a higher Structural Heart Diseases (2022YFC2503400); National
TAVR success rate in the 3DP group (100%) than in the Natural Science Foundation (82370375); Research on Key
non-3DP group (96.4%), along with shorter total operating Techniques of Minimally Invasive Treatment for Valvular
time, digital subtraction angiography time, and reduced Heart Diseases (2023-YBSF-105); Xijing Hospital Booster
radiation exposure. Furthermore, no patients in the 3DP Foundation (XJZT24LY42); and Safety and Efficacy of
group experienced major procedural complications. In 3D Printing in Transcatheter Aortic Valve Replacement:
particular, the incidence of ≥ mild PVL was significantly A National Multicenter, Prospective Study Program
lower in the 3DP group than in the non-3DP group, which (XJZT24LY42).
yielded even more promising results than previous clinical
studies. Naturally, further research is needed to confirm Conflict of interest
24
these findings. Importantly, our data demonstrated that the The authors declare they have no conflicts of interest.
post-procedural coaxiality index was strongly correlated
with the coaxial angle. In addition to horizocardia, the Author contributions
coaxiality index was identified as an independent predictor Conceptualization: Yu Mao, Yang Liu
of PVL. As expected, the 3DP group showed superior Formal analysis: Yiwei Wang, Yanyan Ma, Zhenge Fan,
coaxiality performance compared to the non-3DP group. Mengen Zhai, Ping Jin, Fangyao Chen, Yuhui Yang
These results may have implications for future procedural Investigation: Yingqiang Guo, Gejun Zhang, Haibo Zhang,
planning in TAVR, with the potential to reduce the risk of Lai Wei, Jian Liu, Xiangbin Pan, Jian Yang
PVL after implantation. Methodology: Yu Mao, Yang Liu, Jian Yang
In addition, the incidence of the complete atrioventricular Writing-original draft: Yang Liu, Xiangbin Pan, Jian Yang
heart block group was lower in the 3DP group than in Writing-review & editing: Yingqiang Guo, Haibo Zhang,
the non-3DP group (0% vs. 6.77%). This reduction may Lai Wei, Jian Liu, Jincheng Liu, Xiangbin Pan, Jian
be attributed to the three positioning keys anchoring the Yang
base of the aortic sinus before valve deployment. Improper
positioning, specifically deeper localization, can cause Ethics approval and consent to participate
the device to compress the membranous interventricular The protocol was approved by the Ethics Committee of
septum, leading to conduction block. Xijing Hospital (approval number: KY-20192138-C-1). All

Volume 11 Issue 4 (2025) 61 doi: 10.36922/jctr.24.00084