PMID- 34090956
OWN - NLM
STAT- MEDLINE
DCOM- 20210804
LR  - 20210804
IS  - 1874-1754 (Electronic)
IS  - 0167-5273 (Linking)
VI  - 338
DP  - 2021 Sep 1
TI  - Aortic angle distribution and predictors of horizontal aorta in patients 
      undergoing transcatheter aortic valve replacement.
PG  - 58-62
LID - S0167-5273(21)00911-6 [pii]
LID - 10.1016/j.ijcard.2021.05.054 [doi]
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 degrees  +/- 9.4 degrees  (median 49 degrees , inter-quartile range [IQR] 12 degrees , range 
      18-90 degrees ). There was no significant difference in mean AA between men and women 
      (49.4 degrees  +/- 9.1 degrees  vs. 49.6 degrees  +/- 9.3 degrees , respectively; p = 0.53); therefore, 49.4 degrees  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 degrees  as the mean 
      AA, and also associated predictors of HA in a large case series of patients with 
      severe aortic stenosis candidates for TAVR.
CI  - Copyright (c) 2021 Elsevier B.V. All rights reserved.
FAU - Moscarelli, Marco
AU  - Moscarelli M
AD  - Department of Cardiovascular Surgery, GVM Care & Research, Bari, Italy. 
      Electronic address: m.moscarelli@imperial.ac.uk.
FAU - Gallo, Francesco
AU  - Gallo F
AD  - Interventional Cardiology Unit, Maria Cecilia Hospital, GVM Care and Research, 
      Italy.
FAU - Gallone, Guglielmo
AU  - Gallone G
AD  - Azienda Ospedaliera Universitaria Citta della Salute e della Scienza di Torino, 
      Turin, Italy.
FAU - Kim, Won-Keun
AU  - Kim WK
AD  - Department of Cardiology, Kerckhoff Heart and Thorax Centre, Bad Nauheim, 
      Germany.
FAU - Reifart, Jorg
AU  - Reifart J
AD  - Department of Cardiology, Kerckhoff Heart and Thorax Centre, Bad Nauheim, 
      Germany.
FAU - Veulemans, Verena
AU  - Veulemans V
AD  - Division of Cardiology, Pulmonology and Vascular Medicine, Heinrich Heine 
      University, Dusseldorf, Germany.
FAU - Zeus, Tobias
AU  - Zeus T
AD  - Division of Cardiology, Pulmonology and Vascular Medicine, Heinrich Heine 
      University, Dusseldorf, Germany.
FAU - Toggweiler, Stefan
AU  - Toggweiler S
AD  - Cantonal Hospital Lucerne, Lucerne, Switzerland.
FAU - De Backer, Ole
AU  - De Backer O
AD  - Department of Cardiology, The Heart Centre, Rigshospitalet, Copenhagen University 
      Hospital, Copenhagen, Denmark.
FAU - Sondergaard, Lars
AU  - Sondergaard L
AD  - Department of Cardiology, The Heart Centre, Rigshospitalet, Copenhagen University 
      Hospital, Copenhagen, Denmark.
FAU - Mangieri, Antonio
AU  - Mangieri A
AD  - Interventional Cardiology Unit, Maria Cecilia Hospital, GVM Care and Research, 
      Italy.
FAU - De Marco, Federico
AU  - De Marco F
AD  - Department of Clinical and Interventional Cardiology, IRCCS Policlinico San 
      Donato, San Donato Milanese, Italy.
FAU - Regazzoli, Damiano
AU  - Regazzoli D
AD  - Department of Clinical and Interventional Cardiology, Cardio Center, Humanitas 
      Research Hospital, Rozzano-Milano, Italy.
FAU - Reimers, Bernhard
AU  - Reimers B
AD  - Department of Clinical and Interventional Cardiology, Cardio Center, Humanitas 
      Research Hospital, Rozzano-Milano, Italy.
FAU - Muntane-Carol, Guillem
AU  - Muntane-Carol G
AD  - Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada.
FAU - Lauriero, Rodrigo Estevez
AU  - Lauriero RE
AD  - Interventional Cardiology Unit, Hospital Alvaro Cunqueiro, Vigo, Spain.
FAU - Armario, Xavier
AU  - Armario X
AD  - Department of Cardiology, National University of Ireland, Galway (NUIG), Galway, 
      Ireland.
FAU - Mylotte, Darren
AU  - Mylotte D
AD  - Department of Cardiology, National University of Ireland, Galway (NUIG), Galway, 
      Ireland.
FAU - Bhadra, Oliver Daniel
AU  - Bhadra OD
AD  - Department of Cardiology, University Heart and Vascular Center Hamburg, Hamburg, 
      Germany.
FAU - Conradi, Lenard
AU  - Conradi L
AD  - Department of Cardiology, University Heart and Vascular Center Hamburg, Hamburg, 
      Germany.
FAU - Donday, Luis Alfonso Marroquin
AU  - Donday LAM
AD  - Cardiovascular Institute, Hospital Clinico San Carlos, IdISSC, Madrid, Spain.
FAU - Nombela-Franco, Luis
AU  - Nombela-Franco L
AD  - Cardiovascular Institute, Hospital Clinico San Carlos, IdISSC, Madrid, Spain.
FAU - Barbanti, Marco
AU  - Barbanti M
AD  - Division of Cardiology, A.O.U. Policlinico-Vittorio Emanuele, Catania, Italy.
FAU - Reddavid, Claudia
AU  - Reddavid C
AD  - Division of Cardiology, A.O.U. Policlinico-Vittorio Emanuele, Catania, Italy.
FAU - Brugaletta, Salvatore
AU  - Brugaletta S
AD  - Cardiovascular Institute, Hospital Clinic, Institut d'Investigacions Biomediques 
      August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
FAU - Nicolini, Elisa
AU  - Nicolini E
AD  - Interventional Cardiology, Ospedali Riuniti di Ancona, Ancona, Italy.
FAU - Tzanis, Giorgos
AU  - Tzanis G
AD  - Department of Interventional Cardiology, Henry Dunant Hospital Center, Athens, 
      Greece.
FAU - Rodes-Cabau, Josep
AU  - Rodes-Cabau J
AD  - Department of Clinical and Interventional Cardiology, Cardio Center, Humanitas 
      Research Hospital, Rozzano-Milano, Italy.
FAU - Colombo, Antonio
AU  - Colombo A
AD  - Interventional Cardiology Unit, Maria Cecilia Hospital, GVM Care and Research, 
      Italy.
FAU - Giannini, Francesco
AU  - Giannini F
AD  - Interventional Cardiology Unit, Maria Cecilia Hospital, GVM Care and Research, 
      Italy.
LA  - eng
PT  - Journal Article
DEP - 20210606
PL  - Netherlands
TA  - Int J Cardiol
JT  - International journal of cardiology
JID - 8200291
SB  - IM
MH  - Aorta
MH  - Aortic Valve/diagnostic imaging/surgery
MH  - *Aortic Valve Stenosis/diagnostic imaging/surgery
MH  - Europe
MH  - Female
MH  - Humans
MH  - Male
MH  - Prospective Studies
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Severity of Illness Index
MH  - *Transcatheter Aortic Valve Replacement/adverse effects
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Aortic angle
OT  - Horizontal aorta
OT  - Obesity paradox
OT  - TAVR
OT  - Transcatheter aortic valve replacement
COIS- Declaration of Competing Interest None.
EDAT- 2021/06/07 06:00
MHDA- 2021/08/05 06:00
CRDT- 2021/06/06 20:47
PHST- 2021/04/11 00:00 [received]
PHST- 2021/05/25 00:00 [revised]
PHST- 2021/05/28 00:00 [accepted]
PHST- 2021/06/07 06:00 [pubmed]
PHST- 2021/08/05 06:00 [medline]
PHST- 2021/06/06 20:47 [entrez]
AID - S0167-5273(21)00911-6 [pii]
AID - 10.1016/j.ijcard.2021.05.054 [doi]
PST - ppublish
SO  - Int J Cardiol. 2021 Sep 1;338:58-62. doi: 10.1016/j.ijcard.2021.05.054. Epub 2021 
      Jun 6.