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

Abstract

AIMS\nTo evaluate the impact of 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 NBE (n = 447) and BE (n = 100) TAVI for symptomatic severe aortic stenosis. Aortic angulation (AA) was evaluated with pre-procedural computed tomography. Patients were dichotomized 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 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 balloon (BE) and non balloon-expandable (NBE) prostheses.\n\n\nCONCLUSIONS\nThe presence of HA has no impact on device success and short-term clinical outcomes of TAVI with either second-generation NBE or BE devices.