The Accurate Commissural Alignment (ACA) Project

Controlled commissural alignment of TAVI can be achieved by planning a patient-specific orientation of the prosthesis before crimping and advancing the delivery system within the vascular anatomy in the recommended orientation.

  • - Risk of coronary obstruction during the implantation is reduced.
  • - Better hemodynamics might be associated to longer valve durability.
  • - Access to coronary ostia, if required, can be easier if the alignment of commissures is adequate.

You can submit your own anonymized CT scans for offline analysis.

The ACA Project

The TAVI commissure alignment method has been validated in a three stage research project

  • - In silico simulation
  • - Bench test in 3D printed models
  • - In vivo proof-of-concept

In silico simulation

Centerline of the aorta, from the descending aorta to the aortic root and left is calculated from CT-derived aortic biomodels. Assuming no torsion of the delivery catheter, the TAVI is advanced virtually through the aorta with rotational orientation perpendicular to the centerline curve of the aorta

Bench test in 3D printed models

Real TAVI valves were implanted in ten CT-derived hollowed 3D printed-phantoms obtained from aortic biomodels. CT-scans of the 3D-printed models were obtained for in silico versus in vitro comparison of both, conventional and ACA oriented implants.

In vivo proof-of-concept

19 consecutive patients with aortic stenosis accepted for TAVI have been implanted with the ACA methodology. 5 different TAVI valves from different providers have been employed. Average radial deviation from optimal target angle is less than 8º

Multicenter registry

A multicenter registry to evaluate mid-term improvement in clinical parameters soon to be started.

We offer our ACA analysis services remotely for anyone interested. Please, fill in the form with your contact details, the number of cases you want us to analyze and any additional comments describing cases or context, and we will contact you back with a quote and a link for you to upload CT-scan images through a secure server. CT-images uploaded this way have to be FULLY ANONIMIZED in any case.