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.
I: International Journal of Cardiology, Bind 338, 2021, s. 58-62.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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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 - Funding Information: The authors would like to thank Dr. Ashley Symons (symonsediting@gmail.com) for professional scientific editing of this article. Publisher Copyright: © 2021 Elsevier B.V.
PY - 2021
Y1 - 2021
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 - Aortic angle
KW - Horizontal aorta
KW - Obesity paradox
KW - TAVR
KW - Transcatheter aortic valve replacement
U2 - 10.1016/j.ijcard.2021.05.054
DO - 10.1016/j.ijcard.2021.05.054
M3 - Journal article
C2 - 34090956
AN - SCOPUS:85107609774
VL - 338
SP - 58
EP - 62
JO - International Journal of Cardiology
JF - International Journal of Cardiology
SN - 0167-5273
ER -
ID: 302196481