Aortic angle distribution and predictors of horizontal aorta in patients undergoing transcatheter aortic valve replacement
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Aortic angle distribution and predictors of horizontal aorta in patients undergoing transcatheter aortic valve replacement. / Moscarelli, Marco; Gallo, Francesco; Gallone, Guglielmo; Kim, Won-Keun; Reifart, Jörg; Veulemans, Verena; Zeus, Tobias; Toggweiler, Stefan; De Backer, Ole; Søndergaard, Lars; Mangieri, Antonio; De Marco, Federico; Regazzoli, Damiano; Reimers, Bernhard; Muntané-Carol, Guillem; Lauriero, Rodrigo Estevez; Armario, Xavier; Mylotte, Darren; Bhadra, Oliver Daniel; Conradi, Lenard; Donday, Luis Alfonso Marroquin; Nombela-Franco, Luis; Barbanti, Marco; Reddavid, Claudia; Brugaletta, Salvatore; Nicolini, Elisa; Tzanis, Giorgos; Rodes-Cabau, Josep; Colombo, Antonio; Giannini, Francesco.
in: INT J CARDIOL, Jahrgang 338, 01.09.2021, S. 58-62.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Aortic angle distribution and predictors of horizontal aorta in patients undergoing transcatheter aortic valve replacement
AU - Moscarelli, Marco
AU - Gallo, Francesco
AU - Gallone, Guglielmo
AU - Kim, Won-Keun
AU - Reifart, Jörg
AU - Veulemans, Verena
AU - Zeus, Tobias
AU - Toggweiler, Stefan
AU - De Backer, Ole
AU - Søndergaard, Lars
AU - Mangieri, Antonio
AU - De Marco, Federico
AU - Regazzoli, Damiano
AU - Reimers, Bernhard
AU - Muntané-Carol, Guillem
AU - Lauriero, Rodrigo Estevez
AU - Armario, Xavier
AU - Mylotte, Darren
AU - Bhadra, Oliver Daniel
AU - Conradi, Lenard
AU - Donday, Luis Alfonso Marroquin
AU - Nombela-Franco, Luis
AU - Barbanti, Marco
AU - Reddavid, Claudia
AU - Brugaletta, Salvatore
AU - Nicolini, Elisa
AU - Tzanis, Giorgos
AU - Rodes-Cabau, Josep
AU - Colombo, Antonio
AU - Giannini, Francesco
N1 - Copyright © 2021 Elsevier B.V. All rights reserved.
PY - 2021/9/1
Y1 - 2021/9/1
N2 - BACKGROUND: Horizontal aorta (HA) is an anatomical feature that can pose significant technical challenges for the successful positioning of the bioprosthetic valve during transcatheter aortic valve replacement (TAVR). Physiological range of aortic angle (AA) is unknown; hence there is no cutoff AA for classifying HA. Moreover, patient characteristics predicting HA are under-investigated.METHODS: This was a retrospective analysis of prospective collected data from 16 heart valve centers in Europe. The study utilized a common dataset with a priori agreed-upon definitions and variables. Eligible patients underwent TAVR between 2014 and 2020 and had multidetector computed tomographic imaging data available for determining the AA. The analysis described the distribution of AA and potential predictors of HA. Inter-center variability was also explored.RESULTS: For 4022 patients analyzed, the mean AA ± standard deviation was 49.4° ± 9.4° (median 49°, inter-quartile range [IQR] 12°, range 18-90°). There was no significant difference in mean AA between men and women (49.4° ± 9.1° vs. 49.6° ± 9.3°, respectively; p = 0.53); therefore, 49.4° was accepted as the cutoff value for HA in subsequent analyses. Covariates significantly associated with HA included age (odds ratio [OR]: 1.02, 95% confidence interval [CI]: 1.01-1.04, p < 0.001), body mass index (OR: 1.06, 95% CI: 1.05-1.08, p < 0.01), previous cardiac surgery (OR: 0.58, 95% CI: 0.45-0.75, p < 0.001), and porcelain aorta (OR: 0.66, 95% CI: 0.52-0.85, p = 0.001). Some inter-center variability was observed.CONCLUSIONS: We defined 49.4° as the mean AA, and also associated predictors of HA in a large case series of patients with severe aortic stenosis candidates for TAVR.
AB - BACKGROUND: Horizontal aorta (HA) is an anatomical feature that can pose significant technical challenges for the successful positioning of the bioprosthetic valve during transcatheter aortic valve replacement (TAVR). Physiological range of aortic angle (AA) is unknown; hence there is no cutoff AA for classifying HA. Moreover, patient characteristics predicting HA are under-investigated.METHODS: This was a retrospective analysis of prospective collected data from 16 heart valve centers in Europe. The study utilized a common dataset with a priori agreed-upon definitions and variables. Eligible patients underwent TAVR between 2014 and 2020 and had multidetector computed tomographic imaging data available for determining the AA. The analysis described the distribution of AA and potential predictors of HA. Inter-center variability was also explored.RESULTS: For 4022 patients analyzed, the mean AA ± standard deviation was 49.4° ± 9.4° (median 49°, inter-quartile range [IQR] 12°, range 18-90°). There was no significant difference in mean AA between men and women (49.4° ± 9.1° vs. 49.6° ± 9.3°, respectively; p = 0.53); therefore, 49.4° was accepted as the cutoff value for HA in subsequent analyses. Covariates significantly associated with HA included age (odds ratio [OR]: 1.02, 95% confidence interval [CI]: 1.01-1.04, p < 0.001), body mass index (OR: 1.06, 95% CI: 1.05-1.08, p < 0.01), previous cardiac surgery (OR: 0.58, 95% CI: 0.45-0.75, p < 0.001), and porcelain aorta (OR: 0.66, 95% CI: 0.52-0.85, p = 0.001). Some inter-center variability was observed.CONCLUSIONS: We defined 49.4° as the mean AA, and also associated predictors of HA in a large case series of patients with severe aortic stenosis candidates for TAVR.
KW - Aorta
KW - Aortic Valve/diagnostic imaging
KW - Aortic Valve Stenosis/diagnostic imaging
KW - Europe
KW - Female
KW - Humans
KW - Male
KW - Prospective Studies
KW - Retrospective Studies
KW - Risk Factors
KW - Severity of Illness Index
KW - Transcatheter Aortic Valve Replacement/adverse effects
KW - Treatment Outcome
U2 - 10.1016/j.ijcard.2021.05.054
DO - 10.1016/j.ijcard.2021.05.054
M3 - SCORING: Journal article
C2 - 34090956
VL - 338
SP - 58
EP - 62
JO - INT J CARDIOL
JF - INT J CARDIOL
SN - 0167-5273
ER -
