Horizontal Aorta in Transcatheter Self-Expanding Valves: Insights From the HORSE International Multicentre Registry
Standard
Horizontal Aorta in Transcatheter Self-Expanding Valves: Insights From the HORSE International Multicentre Registry. / Gallo, Francesco; Gallone, Guglielmo; Kim, Won-Keun; Reifart, Jörg; Veulemans, Verena; Zeus, Tobias; Toggweiler, Stefan; De Backer, Ole; Søndergaard, Lars; Mangieri, Antonio; Khokhar, Arif; De Marco, Federico; Regazzoli, Damiano; Reimers, Bernhard; Muntané-Carol, Guillem; Estévez-Loureiro, Rodrigo; Espino, Antonio; Moscarelli, Marco; Armario, Xavier; Mylotte, Darren; Gorla, Riccardo; Bhadra, Oliver Daniel; Conradi, Lenard; Marroquin Donday, Luis Alfonso; Nombela-Franco, Luis; Barbanti, Marco; Reddavid, Claudia; Criscione, Enrico; Brugaletta, Salvatore; Regueiro, Ander; Pérez-Fuentes, Pedro; Nicolini, Elisa; Piva, Tommaso; Tzanis, Giorgos; Rodes-Cabau, Josep; Colombo, Antonio; Giannini, Francesco.
in: CIRC-CARDIOVASC INTE, Jahrgang 14, Nr. 9, e010641, 09.2021.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
Harvard
APA
Vancouver
Bibtex
}
RIS
TY - JOUR
T1 - Horizontal Aorta in Transcatheter Self-Expanding Valves: Insights From the HORSE International Multicentre Registry
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 - Khokhar, Arif
AU - De Marco, Federico
AU - Regazzoli, Damiano
AU - Reimers, Bernhard
AU - Muntané-Carol, Guillem
AU - Estévez-Loureiro, Rodrigo
AU - Espino, Antonio
AU - Moscarelli, Marco
AU - Armario, Xavier
AU - Mylotte, Darren
AU - Gorla, Riccardo
AU - Bhadra, Oliver Daniel
AU - Conradi, Lenard
AU - Marroquin Donday, Luis Alfonso
AU - Nombela-Franco, Luis
AU - Barbanti, Marco
AU - Reddavid, Claudia
AU - Criscione, Enrico
AU - Brugaletta, Salvatore
AU - Regueiro, Ander
AU - Pérez-Fuentes, Pedro
AU - Nicolini, Elisa
AU - Piva, Tommaso
AU - Tzanis, Giorgos
AU - Rodes-Cabau, Josep
AU - Colombo, Antonio
AU - Giannini, Francesco
PY - 2021/9
Y1 - 2021/9
N2 - Background:An increased degree of aortic angulation (AA) represents a challenging feature for bioprosthesis positioning. Whether AA has an impact on procedural outcomes of contemporary self-expanding valves remains unsettled. The aim of this study was to evaluate the impact of AA on procedural outcomes of transcatheter aortic valve replacement with contemporary self-expanding valves.Methods:The HORSE (Horizontal Aorta in Transcatheter Self-Expanding Valves) is an international, retrospective registry including 3862 consecutive patients undergoing transcatheter aortic valve replacement with either Evolut R/PRO (n=1959) or ACURATE neo (n=1903) devices. Patients undergoing Evolut R 34 mm implantation were excluded as no comparable prosthesis size for ACURATE neo is available. AA was evaluated with preprocedural computed tomography, and its impact on device success was evaluated.Results:In the overall population, AA did not have any impact upon device success, also when adjusting for in-study outcome predictors (odds ratio for 1° increment, 0.99 [95% CI, 0.98–1.01], P=0.306). However, increased AA was associated with lower device success with use of the Evolut R/PRO valves (odds ratio, 0.97 [95% CI, 0.95–0.99]; P=0.004), but not the ACURATE neo valves (odds ratio, 1.00 [95% CI, 0.98–1.03], P=0.304). The best AA cutoff value predicting device success was 49° (47% of the study cohort). Among patients with AA≥49°, Evolut R/PRO valves were associated with lower device success as compared to the ACURATE neo valve (inverse probability weighting odds ratio, 0.62 [95% CI, 0.46–0.83]; P=0.002).Conclusions:Horizontal aorta, as defined by an AA ≥49°, is a common feature among transcatheter aortic valve replacement candidates and predicts device failure of the Evolut R/PRO valves, but not of the ACURATE neo valve. AA may be an effect modifier of the association between self-expanding valve type and device success.
AB - Background:An increased degree of aortic angulation (AA) represents a challenging feature for bioprosthesis positioning. Whether AA has an impact on procedural outcomes of contemporary self-expanding valves remains unsettled. The aim of this study was to evaluate the impact of AA on procedural outcomes of transcatheter aortic valve replacement with contemporary self-expanding valves.Methods:The HORSE (Horizontal Aorta in Transcatheter Self-Expanding Valves) is an international, retrospective registry including 3862 consecutive patients undergoing transcatheter aortic valve replacement with either Evolut R/PRO (n=1959) or ACURATE neo (n=1903) devices. Patients undergoing Evolut R 34 mm implantation were excluded as no comparable prosthesis size for ACURATE neo is available. AA was evaluated with preprocedural computed tomography, and its impact on device success was evaluated.Results:In the overall population, AA did not have any impact upon device success, also when adjusting for in-study outcome predictors (odds ratio for 1° increment, 0.99 [95% CI, 0.98–1.01], P=0.306). However, increased AA was associated with lower device success with use of the Evolut R/PRO valves (odds ratio, 0.97 [95% CI, 0.95–0.99]; P=0.004), but not the ACURATE neo valves (odds ratio, 1.00 [95% CI, 0.98–1.03], P=0.304). The best AA cutoff value predicting device success was 49° (47% of the study cohort). Among patients with AA≥49°, Evolut R/PRO valves were associated with lower device success as compared to the ACURATE neo valve (inverse probability weighting odds ratio, 0.62 [95% CI, 0.46–0.83]; P=0.002).Conclusions:Horizontal aorta, as defined by an AA ≥49°, is a common feature among transcatheter aortic valve replacement candidates and predicts device failure of the Evolut R/PRO valves, but not of the ACURATE neo valve. AA may be an effect modifier of the association between self-expanding valve type and device success.
KW - Aorta
KW - Aortic Valve/diagnostic imaging
KW - Aortic Valve Stenosis/diagnostic imaging
KW - Bioprosthesis
KW - Heart Valve Prosthesis
KW - Humans
KW - Prosthesis Design
KW - Registries
KW - Transcatheter Aortic Valve Replacement/adverse effects
KW - Treatment Outcome
U2 - 10.1161/CIRCINTERVENTIONS.121.010641
DO - 10.1161/CIRCINTERVENTIONS.121.010641
M3 - SCORING: Journal article
C2 - 34455799
VL - 14
JO - CIRC-CARDIOVASC INTE
JF - CIRC-CARDIOVASC INTE
SN - 1941-7640
IS - 9
M1 - e010641
ER -