Aortic annulus angulation does not attenuate procedural success of transcatheter aortic valve replacement using a novel self-expanding bioprosthesis
The objectives of the study were to evaluate the impact of aortic angulation (AA) on success of transcatheter aortic valve replacement (TAVR) with a new generation self-expandable prosthesis (Medtronic Evolut R®). Specific anatomical conditions, such as for example the presence of a horizontal aorta...
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| Veröffentlicht in: | Heart and vessels 2019-12, Vol.34 (12), p.1969-1975 |
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| container_issue | 12 |
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| container_title | Heart and vessels |
| container_volume | 34 |
| creator | D’Ancona, Giuseppe Kische, Stephan El-Mawardy, Mohamed Dißmann, Martin Heinze, Helmut Zohlnhöfer-Momm, Dietlind Gürer, Hakan Ince, Hüseyin |
| description | The objectives of the study were to evaluate the impact of aortic angulation (AA) on success of transcatheter aortic valve replacement (TAVR) with a new generation self-expandable prosthesis (Medtronic Evolut R®). Specific anatomical conditions, such as for example the presence of a horizontal aorta with elevated AA, have seemed to pose a significant challenge for the correct positioning and consequent functioning of self-expandable TAVR prostheses. We assessed 146 patients treated with Evolut R. AA was measured at computed tomography and two groups were identified using as cutoff the mean AA value. Acute outcomes were collected and compared. AA mean value was 49.6 ± 9.4° (AA ≥ 50°: 76 and AA |
| doi_str_mv | 10.1007/s00380-019-01436-8 |
| format | Article |
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p
= 0.8) was equivalent. Perioperative results were similar: valve resheathing (AA ≥ 50°: 21.0% vs. AA < 50°: 24.2%;
p
= 0.6), recapturing (AA ≥ 50°: 19.7% vs. AA < 50°: 25.7%;
p
= 0.3), fluoroscopy time (AA ≥ 50°: 11.1 IQR: 8.6–17.0 min. vs. AA < 50°: 11.0 IQR: 8.0–15.7 min.;
p
= 0.9), and contrast agent use (AA ≥ 50°: 99.0 ± 41.8 ml. vs. AA < 50°: 104.2 ± 38.5 ml.;
p
= 0.4). At discharge, moderate paravalvular leak was present in 8/76 (10.5%) of the AA ≥ 50° and 6/70 (8.6%) of the AA < 50° (
p
= 0.7) patients. Severe paravalvular leak, implantation of a second valve, and/or conversion to surgery did not occur. Early safety (AA ≥ 50°: 7.8% vs. AA < 50°: 5.7%;
p
= 0.6) was similar in the two groups. AA did not affect procedural outcomes and valve performance of the Evolut R prosthesis.]]></description><identifier>ISSN: 0910-8327</identifier><identifier>EISSN: 1615-2573</identifier><identifier>DOI: 10.1007/s00380-019-01436-8</identifier><identifier>PMID: 31134380</identifier><language>eng</language><publisher>Tokyo: Springer Japan</publisher><subject>Aged, 80 and over ; Aorta ; Aorta, Thoracic - diagnostic imaging ; Aortic valve ; Aortic Valve - diagnostic imaging ; Aortic Valve - surgery ; Aortic Valve Stenosis - diagnosis ; Aortic Valve Stenosis - surgery ; Biomedical Engineering and Bioengineering ; Bioprosthesis ; Cardiac Surgery ; Cardiology ; Computed tomography ; Contrast agents ; Female ; Fluoroscopy ; Follow-Up Studies ; Heart Valve Prosthesis ; Humans ; Implantation ; Male ; Medicine ; Medicine & Public Health ; Original Article ; Prostheses ; Prosthesis Design ; Prosthetics ; Retrospective Studies ; Risk assessment ; Risk Factors ; Severity of Illness Index ; Surgery ; Time Factors ; Tomography, X-Ray Computed ; Transcatheter Aortic Valve Replacement - methods ; Treatment Outcome ; Vascular Surgery</subject><ispartof>Heart and vessels, 2019-12, Vol.34 (12), p.1969-1975</ispartof><rights>Springer Japan KK, part of Springer Nature 2019</rights><rights>Springer Japan KK, part of Springer Nature 2019.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c399t-942811d9b320a1aad6aca008d97e8343d67bd5404a52081be9f672ed2f44af023</citedby><cites>FETCH-LOGICAL-c399t-942811d9b320a1aad6aca008d97e8343d67bd5404a52081be9f672ed2f44af023</cites><orcidid>0000-0002-4004-4521</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00380-019-01436-8$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00380-019-01436-8$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31134380$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>D’Ancona, Giuseppe</creatorcontrib><creatorcontrib>Kische, Stephan</creatorcontrib><creatorcontrib>El-Mawardy, Mohamed</creatorcontrib><creatorcontrib>Dißmann, Martin</creatorcontrib><creatorcontrib>Heinze, Helmut</creatorcontrib><creatorcontrib>Zohlnhöfer-Momm, Dietlind</creatorcontrib><creatorcontrib>Gürer, Hakan</creatorcontrib><creatorcontrib>Ince, Hüseyin</creatorcontrib><title>Aortic annulus angulation does not attenuate procedural success of transcatheter aortic valve replacement using a novel self-expanding bioprosthesis</title><title>Heart and vessels</title><addtitle>Heart Vessels</addtitle><addtitle>Heart Vessels</addtitle><description><![CDATA[The objectives of the study were to evaluate the impact of aortic angulation (AA) on success of transcatheter aortic valve replacement (TAVR) with a new generation self-expandable prosthesis (Medtronic Evolut R®). Specific anatomical conditions, such as for example the presence of a horizontal aorta with elevated AA, have seemed to pose a significant challenge for the correct positioning and consequent functioning of self-expandable TAVR prostheses. We assessed 146 patients treated with Evolut R. AA was measured at computed tomography and two groups were identified using as cutoff the mean AA value. Acute outcomes were collected and compared. AA mean value was 49.6 ± 9.4° (AA ≥ 50°: 76 and AA < 50°: 70 patients). Risk profile (Logistic euroSCORE: AA ≥ 50°: 15.7; 75% IQR: 11.1–22.1 vs. AA < 50°: 14.7; 75% IQR: 10.7–24.0;
p
= 0.8) was equivalent. Perioperative results were similar: valve resheathing (AA ≥ 50°: 21.0% vs. AA < 50°: 24.2%;
p
= 0.6), recapturing (AA ≥ 50°: 19.7% vs. AA < 50°: 25.7%;
p
= 0.3), fluoroscopy time (AA ≥ 50°: 11.1 IQR: 8.6–17.0 min. vs. AA < 50°: 11.0 IQR: 8.0–15.7 min.;
p
= 0.9), and contrast agent use (AA ≥ 50°: 99.0 ± 41.8 ml. vs. AA < 50°: 104.2 ± 38.5 ml.;
p
= 0.4). At discharge, moderate paravalvular leak was present in 8/76 (10.5%) of the AA ≥ 50° and 6/70 (8.6%) of the AA < 50° (
p
= 0.7) patients. Severe paravalvular leak, implantation of a second valve, and/or conversion to surgery did not occur. Early safety (AA ≥ 50°: 7.8% vs. AA < 50°: 5.7%;
p
= 0.6) was similar in the two groups. AA did not affect procedural outcomes and valve performance of the Evolut R prosthesis.]]></description><subject>Aged, 80 and over</subject><subject>Aorta</subject><subject>Aorta, Thoracic - diagnostic imaging</subject><subject>Aortic valve</subject><subject>Aortic Valve - diagnostic imaging</subject><subject>Aortic Valve - surgery</subject><subject>Aortic Valve Stenosis - diagnosis</subject><subject>Aortic Valve Stenosis - surgery</subject><subject>Biomedical Engineering and Bioengineering</subject><subject>Bioprosthesis</subject><subject>Cardiac Surgery</subject><subject>Cardiology</subject><subject>Computed tomography</subject><subject>Contrast agents</subject><subject>Female</subject><subject>Fluoroscopy</subject><subject>Follow-Up Studies</subject><subject>Heart Valve Prosthesis</subject><subject>Humans</subject><subject>Implantation</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Original Article</subject><subject>Prostheses</subject><subject>Prosthesis Design</subject><subject>Prosthetics</subject><subject>Retrospective Studies</subject><subject>Risk assessment</subject><subject>Risk Factors</subject><subject>Severity of Illness Index</subject><subject>Surgery</subject><subject>Time Factors</subject><subject>Tomography, X-Ray Computed</subject><subject>Transcatheter Aortic Valve Replacement - methods</subject><subject>Treatment Outcome</subject><subject>Vascular Surgery</subject><issn>0910-8327</issn><issn>1615-2573</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kc2KFTEQhYMozp3RF3AhATduWvPTP8lyGEYdGHCj61CdVF976Ju-ppKLvocPbMYeFVy4CAXJOV9V5TD2Qoo3UojhLQmhjWiEtPW0um_MI7aTvewa1Q36MdsJK0VjtBrO2DnRnRCys9I-ZWdaSt1W7479uFxTnj2HGMtSqNZ9WSDPa-RhReJxzRxyxlggIz-m1WMoCRZOxXsk4uvEc4JIHvIXzJg4bMATLCfkCY8LeDxgzLzQHPccKvKE1Y_L1OC3I8Rwfz3Oa4VTZdBMz9iTCRbC5w_1gn1-d_3p6kNz-_H9zdXlbeO1tbmxrTJSBjtqJUAChB48CGGCHdDU_UI_jKFrRQudEkaOaKd-UBjU1LYwCaUv2OuNW1t_LUjZHWbyuCwQcS3klNJKKjv0Q5W--kd6t5YU63ROaVn_22hjq0ptKl93oYSTO6b5AOm7k8LdZ-a2zFzNzP3KzJlqevmALuMBwx_L75CqQG8Cqk9xj-lv7_9gfwLk1KUY</recordid><startdate>20191201</startdate><enddate>20191201</enddate><creator>D’Ancona, Giuseppe</creator><creator>Kische, Stephan</creator><creator>El-Mawardy, Mohamed</creator><creator>Dißmann, Martin</creator><creator>Heinze, Helmut</creator><creator>Zohlnhöfer-Momm, Dietlind</creator><creator>Gürer, Hakan</creator><creator>Ince, Hüseyin</creator><general>Springer Japan</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QO</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>P64</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-4004-4521</orcidid></search><sort><creationdate>20191201</creationdate><title>Aortic annulus angulation does not attenuate procedural success of transcatheter aortic valve replacement using a novel self-expanding bioprosthesis</title><author>D’Ancona, Giuseppe ; Kische, Stephan ; El-Mawardy, Mohamed ; Dißmann, Martin ; Heinze, Helmut ; Zohlnhöfer-Momm, Dietlind ; Gürer, Hakan ; Ince, Hüseyin</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c399t-942811d9b320a1aad6aca008d97e8343d67bd5404a52081be9f672ed2f44af023</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Aged, 80 and over</topic><topic>Aorta</topic><topic>Aorta, Thoracic - diagnostic imaging</topic><topic>Aortic valve</topic><topic>Aortic Valve - diagnostic imaging</topic><topic>Aortic Valve - surgery</topic><topic>Aortic Valve Stenosis - diagnosis</topic><topic>Aortic Valve Stenosis - surgery</topic><topic>Biomedical Engineering and Bioengineering</topic><topic>Bioprosthesis</topic><topic>Cardiac Surgery</topic><topic>Cardiology</topic><topic>Computed tomography</topic><topic>Contrast agents</topic><topic>Female</topic><topic>Fluoroscopy</topic><topic>Follow-Up Studies</topic><topic>Heart Valve Prosthesis</topic><topic>Humans</topic><topic>Implantation</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Original Article</topic><topic>Prostheses</topic><topic>Prosthesis Design</topic><topic>Prosthetics</topic><topic>Retrospective Studies</topic><topic>Risk assessment</topic><topic>Risk Factors</topic><topic>Severity of Illness Index</topic><topic>Surgery</topic><topic>Time Factors</topic><topic>Tomography, X-Ray Computed</topic><topic>Transcatheter Aortic Valve Replacement - methods</topic><topic>Treatment Outcome</topic><topic>Vascular Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>D’Ancona, Giuseppe</creatorcontrib><creatorcontrib>Kische, Stephan</creatorcontrib><creatorcontrib>El-Mawardy, Mohamed</creatorcontrib><creatorcontrib>Dißmann, Martin</creatorcontrib><creatorcontrib>Heinze, Helmut</creatorcontrib><creatorcontrib>Zohlnhöfer-Momm, Dietlind</creatorcontrib><creatorcontrib>Gürer, Hakan</creatorcontrib><creatorcontrib>Ince, Hüseyin</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Heart and vessels</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>D’Ancona, Giuseppe</au><au>Kische, Stephan</au><au>El-Mawardy, Mohamed</au><au>Dißmann, Martin</au><au>Heinze, Helmut</au><au>Zohlnhöfer-Momm, Dietlind</au><au>Gürer, Hakan</au><au>Ince, Hüseyin</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Aortic annulus angulation does not attenuate procedural success of transcatheter aortic valve replacement using a novel self-expanding bioprosthesis</atitle><jtitle>Heart and vessels</jtitle><stitle>Heart Vessels</stitle><addtitle>Heart Vessels</addtitle><date>2019-12-01</date><risdate>2019</risdate><volume>34</volume><issue>12</issue><spage>1969</spage><epage>1975</epage><pages>1969-1975</pages><issn>0910-8327</issn><eissn>1615-2573</eissn><abstract><![CDATA[The objectives of the study were to evaluate the impact of aortic angulation (AA) on success of transcatheter aortic valve replacement (TAVR) with a new generation self-expandable prosthesis (Medtronic Evolut R®). Specific anatomical conditions, such as for example the presence of a horizontal aorta with elevated AA, have seemed to pose a significant challenge for the correct positioning and consequent functioning of self-expandable TAVR prostheses. We assessed 146 patients treated with Evolut R. AA was measured at computed tomography and two groups were identified using as cutoff the mean AA value. Acute outcomes were collected and compared. AA mean value was 49.6 ± 9.4° (AA ≥ 50°: 76 and AA < 50°: 70 patients). Risk profile (Logistic euroSCORE: AA ≥ 50°: 15.7; 75% IQR: 11.1–22.1 vs. AA < 50°: 14.7; 75% IQR: 10.7–24.0;
p
= 0.8) was equivalent. Perioperative results were similar: valve resheathing (AA ≥ 50°: 21.0% vs. AA < 50°: 24.2%;
p
= 0.6), recapturing (AA ≥ 50°: 19.7% vs. AA < 50°: 25.7%;
p
= 0.3), fluoroscopy time (AA ≥ 50°: 11.1 IQR: 8.6–17.0 min. vs. AA < 50°: 11.0 IQR: 8.0–15.7 min.;
p
= 0.9), and contrast agent use (AA ≥ 50°: 99.0 ± 41.8 ml. vs. AA < 50°: 104.2 ± 38.5 ml.;
p
= 0.4). At discharge, moderate paravalvular leak was present in 8/76 (10.5%) of the AA ≥ 50° and 6/70 (8.6%) of the AA < 50° (
p
= 0.7) patients. Severe paravalvular leak, implantation of a second valve, and/or conversion to surgery did not occur. Early safety (AA ≥ 50°: 7.8% vs. AA < 50°: 5.7%;
p
= 0.6) was similar in the two groups. AA did not affect procedural outcomes and valve performance of the Evolut R prosthesis.]]></abstract><cop>Tokyo</cop><pub>Springer Japan</pub><pmid>31134380</pmid><doi>10.1007/s00380-019-01436-8</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-4004-4521</orcidid></addata></record> |
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| subjects | Aged, 80 and over Aorta Aorta, Thoracic - diagnostic imaging Aortic valve Aortic Valve - diagnostic imaging Aortic Valve - surgery Aortic Valve Stenosis - diagnosis Aortic Valve Stenosis - surgery Biomedical Engineering and Bioengineering Bioprosthesis Cardiac Surgery Cardiology Computed tomography Contrast agents Female Fluoroscopy Follow-Up Studies Heart Valve Prosthesis Humans Implantation Male Medicine Medicine & Public Health Original Article Prostheses Prosthesis Design Prosthetics Retrospective Studies Risk assessment Risk Factors Severity of Illness Index Surgery Time Factors Tomography, X-Ray Computed Transcatheter Aortic Valve Replacement - methods Treatment Outcome Vascular Surgery |
| title | Aortic annulus angulation does not attenuate procedural success of transcatheter aortic valve replacement using a novel self-expanding bioprosthesis |
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