Impact of horizontal aorta on procedural and clinical outcomes in second-generation transcatheter aortic valve implantation

EuroIntervention. 2019 Oct 4;15(9):e749-e756. doi: 10.4244/EIJ-D-19-00455.

Abstract

Aims: The aim of this study was to evaluate the impact of a horizontal aorta (HA) on device success and short-term clinical outcomes of transcatheter aortic valve implantation (TAVI).

Methods and results: We retrospectively assessed 547 consecutive patients treated with transfemoral second-generation non-balloon-expandable (NBE) (n=447) and balloon-expandable (BE) (n=100) TAVI for symptomatic severe aortic stenosis. Aortic angulation (AA) was evaluated with preprocedural computed tomography. Patients were dichotomised according to a previously established AA cut-point: HA group (AA ≥48°, n=230) and normal aorta (NA) group (AA <48°, n=317). Endpoints were considered according to the Valve Academic Research Consortium-2 definitions. Fluoroscopy time (32.8±16.4 vs 30.3±13.9 minutes, p=0.060) and radiation dose (kerma area product 120.8±99.7 vs 103.7±81.1 Gy·cm2, p=0.033) were higher in the HA group as compared to the NA group. No difference in device success was observed between patients with and without an HA (88.3% vs 88.0%, p=0.929). No differences in device success and 30-day outcomes were observed when comparing HA and NA patients, according to BE and NBE prostheses.

Conclusions: The presence of an HA has no impact on device success and short-term clinical outcomes of TAVI with either second-generation NBE or BE devices.

MeSH terms

  • Aorta / diagnostic imaging
  • Aortic Valve / surgery*
  • Aortic Valve Stenosis / surgery*
  • Balloon Valvuloplasty / adverse effects
  • Catheterization, Peripheral / adverse effects
  • Fluoroscopy
  • Heart Valve Prosthesis*
  • Humans
  • Prosthesis Design
  • Retrospective Studies
  • Transcatheter Aortic Valve Replacement / adverse effects
  • Transcatheter Aortic Valve Replacement / instrumentation*
  • Treatment Outcome