{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T09:07:28Z","timestamp":1771232848692,"version":"3.50.1"},"reference-count":19,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2020,5,6]],"date-time":"2020-05-06T00:00:00Z","timestamp":1588723200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The impact of a horizontal aorta (HA) on adverse events (AE) following in transcatheter aortic valve replacement (TAVR) is dealt controversially. Using new\u2010generation self\u2010expandable devices, we aimed to reevaluate an appropriate threshold of the aortic root angulation (ARA) in terms of HA and its impact on outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The 466 consecutive patients, who underwent transfemoral TAVR with self\u2010expandable new\u2010generation devices, were analyzed. Patients were classified into cases with HA (ARA\u2009\u2265\u200951\u00b0; <jats:italic>n<\/jats:italic> =\u2009225; 48%) and without HA (ARA\u2009&lt;51\u00b0; <jats:italic>n<\/jats:italic> =\u2009241; 52%). Primary endpoints were device success and 30\u2010day mortality. Secondary endpoints were specific AE according to VARC\u20102 definitions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Contrast use (107.6 \u00b1\u200950.1 vs. 94.1 \u00b1\u200946.1 ml; <jats:italic>p<\/jats:italic> =\u2009.033) and radiation dose (3,176 [1,928\u20135,596] vs. 2,651 [1,643\u20134,394] Gyxcm<jats:sup>2<\/jats:sup>; <jats:italic>p<\/jats:italic> =\u2009.016) were higher in HA. Primary device success was comparable (97.1 vs. 97.8%; <jats:italic>p<\/jats:italic> =\u2009.773). A 30\u2010day mortality (3.3 vs. 0.4%; <jats:italic>p<\/jats:italic> =\u2009.038, plogrank = 0.025), stroke (7.1 vs. 2.7%; <jats:italic>p<\/jats:italic> =\u2009.033), and major vascular complications (MVASC) (6.6 vs. 2.7%; <jats:italic>p<\/jats:italic> =\u2009.050) were more frequent in HA. Pronounced calcification of the noncoronary cusp and left ventricular outflow tract, the condition of HA, as well as repositioning maneuvers were independent predictors for overall specific AE.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>An HA above 51\u00b0 is associated with an increased rate of stroke, MVASC, and 30\u2010day mortality. Valve size and asymmetric calcification affect the incidence of repositioning maneuvers and subsequent VARC\u20102 AE, indicating that an HA\u2014together with specific anatomic features\u2014remains a crucial factor for TAVR\u2010related outcome with self\u2010expandable new\u2010generation devices.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.28961","type":"journal-article","created":{"date-parts":[[2020,5,6]],"date-time":"2020-05-06T20:43:48Z","timestamp":1588797828000},"page":"1511-1519","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Novel insights on outcome in horizontal aorta with self\u2010expandable new\u2010generation transcatheter aortic valve replacement devices"],"prefix":"10.1002","volume":"96","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2744-2154","authenticated-orcid":false,"given":"Verena","family":"Veulemans","sequence":"first","affiliation":[{"name":"Division of Cardiology, Pulmonology and Vascular Medicine Heinrich Heine University, Medical Faculty  D\u00fcsseldorf Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7277-1213","authenticated-orcid":false,"given":"Oliver","family":"Maier","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Pulmonology and Vascular Medicine Heinrich Heine University, Medical Faculty  D\u00fcsseldorf Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Georg","family":"Bosbach","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Pulmonology and Vascular Medicine Heinrich Heine University, Medical Faculty  D\u00fcsseldorf Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5891-9672","authenticated-orcid":false,"given":"Amin","family":"Polzin","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Pulmonology and Vascular Medicine Heinrich Heine University, Medical Faculty  D\u00fcsseldorf Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9746-7592","authenticated-orcid":false,"given":"Kerstin","family":"Piayda","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Pulmonology and Vascular Medicine Heinrich Heine University, Medical Faculty  D\u00fcsseldorf Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shazia","family":"Afzal","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Pulmonology and Vascular Medicine Heinrich Heine University, Medical Faculty  D\u00fcsseldorf Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian","family":"Jung","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Pulmonology and Vascular Medicine Heinrich Heine University, Medical Faculty  D\u00fcsseldorf 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