Effect of Aortic Angulation on Outcomes in Transcatheter Aortic Valve Implantation with the Self-Expanding Portico Valve

Authors : Serkan ASLAN, Aysel TÜRKVATAN, Ahmet GÜNER, Serkan KAHRAMAN, Ümit BULUT, Gökhan DEMİRCİ, Enes ARSLAN, Ömer ÇELİK, Mehmet ERTÜRK

Pages : 132-140

View : 25 | Download : 12

Publication Date : 2022-08-20

Article Type : Research Paper

Abstract :Introduction: Aortic angulation insert ignore into journalissuearticles values(AA);, defined as the angle between the aortic annulus plane and the horizontal plane, may result in failed prosthesis positioning. The effect of AA on the procedural and short-term outcomes with the portico valves for transcatheter aortic valve implantation insert ignore into journalissuearticles values(TAVI); has not been fully investigated. The present study aimed to evaluate the impact of AA on device success and early outcomes of TAVI using a selfexpanding portico valve. Patients and Methods: Preoperative computed tomography scans of 121 consecutive patients treated with the portico valve were analyzed. TAVI device success and outcomes were determined according to VARC-3 definitions. Patients were divided into two groups based on mean AA. Results: The mean AA was 48.7 ± 8.9°. There were no differences in technical success insert ignore into journalissuearticles values(92.2 vs 89.5%, p= 0.604);, device success insert ignore into journalissuearticles values(81.2% vs 77.2%, p= 0.582);, and early safety endpoints insert ignore into journalissuearticles values(68.8% vs 61.4%, p= 0.397); between the AA≤ 48° and AA> 48° groups. The frequency and severity of paravalvular aortic regurgitation insert ignore into journalissuearticles values(PAR); was statistically higher in patients with AA> 48° insert ignore into journalissuearticles values(p= 0.028);. Moreover, an increased AA was also associated with valve malposition insert ignore into journalissuearticles values(12.3% vs. 1.6%, p= 0.018);, prolonged procedure time insert ignore into journalissuearticles values(85 ± 26 vs. 75 ± 20 minutes, p= 0.028);, and greater Δimplantation depth insert ignore into journalissuearticles values(2.2 ± 0.5 vs. 0.8 ± 0.1 mm; p< 0.001);. Conclusion: Despite comparable device success and early outcomes rates, increased AA is associated with higher rates of PAR and valve malposition, with the self-expanding portico valve.
Keywords : Aortic angulation, computed tomography, self expanding valve, transcatheter aortic valve implantation