Correlation Between Aortic Angulation and Outcomes of Transcatheter Aortic Valve Replacement With New-Generation Valves

The aim of this study was to assess the correlation of aortic angulation (AA) on immediate postprocedural and long-term outcomes following transcatheter aortic valve replacement (TAVR) with new-generation valves. There is limited and conflicting data on the impact of AA on shortand long-term outcomes in patients undergoing TAVR. Available studies to date were done with first -generation valves. We assessed 179 patients who underwent TAVR with either a balloon-expandable or self-expandable valve at our institute from May 2014 to June 2017 and had multislice computed tomography scans available for AA evaluation. All included patients received a second- or third-generation valve. TAVR endpoints, device success, and adverse events were defined according to the Valve Academic Research Consortium-2 criteria. The mean AA of the study population was 49.05 +/- 10.07. Patients were divided into 2 groups: AA <49 and AA >= 49 and AA <49 and AA >= 49 groups. The preimplantation balloon valvuloplasty rate was higher in patients with AA >= 49 compared to patients with AA <49, (70% vs 55.1%, P = 0.04). There was no difference in re-hospitalization, pacemaker implantation, post procedural aortic regurgitation or mortality between patients with AA <49 and AA >= 49 irrespective of valve type (P < 0.05). AA does not significantly affect shortor long-term outcomes in patients who undergo TAVR with new-generation balloon-expandable or self-expandable valves.