{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T02:10:16Z","timestamp":1740103816122,"version":"3.37.3"},"reference-count":23,"publisher":"Wiley","issue":"S1","license":[{"start":{"date-parts":[[2022,1,30]],"date-time":"2022-01-30T00:00:00Z","timestamp":1643500800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81570233","81770252","81870292"],"award-info":[{"award-number":["81570233","81770252","81870292"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To evaluate the feasibility of self\u2010expanding transcatheter aortic valve replacement (TAVR) in patients with aortic stenosis and extremely horizontal aortas (aortic angulation \u226570\u00b0).<\/jats:p><\/jats:sec><jats:sec><jats:title>Background<\/jats:title><jats:p>As TAVR using a self\u2010expanding prosthesis is an off\u2010label treatment for patients with extremely horizontal aortas, these patients are often excluded from randomized controlled trials involving self\u2010expanding TAVR.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study enrolled 27 consecutive patients with extremely horizontal aortas who underwent self\u2010expanding TAVR for severe aortic stenosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The patients' average age was 76.4 years, with a median Society of Thoracic Surgeons score of 4.53%. The device success and 30\u2010day mortality rates were 66.7% and 7.4%, respectively. The sinotubular junction (STJ) was significantly smaller in the device success group (<jats:italic>p<\/jats:italic>\u2009=\u20090.001). The receiver operating characteristic curve analysis found that the area under the curve was 0.907 (95% confidence interval: 0.790\u20131.000, <jats:italic>p<\/jats:italic>\u2009=\u20090.001), validating the association between STJ diameter and device success. An optimal cutoff of 33.6 mm was determined using the Youden index, with a sensitivity and specificity of 88.9% and 77.8%, respectively. The device success rate was significantly higher (93.3% vs. 33.3%, <jats:italic>p<\/jats:italic>\u2009=\u20090.003) in patients with STJ diameters \u226433.6\u2009mm (<jats:italic>n<\/jats:italic>\u2009=\u200915). In the subgroup analyses, severe valve calcification (<jats:italic>n<\/jats:italic>\u2009=\u20099) was associated with a higher incidence of moderate or severe paravalvular leakage (44.0% vs. 0%, <jats:italic>p<\/jats:italic>\u2009=\u20090.008), while a higher rate of second valve implantation (60.0% vs. 9.1%, <jats:italic>p<\/jats:italic>\u2009=\u20090.030) was found in patients with less than moderate valve calcification (<jats:italic>n<\/jats:italic>\u2009=\u20095).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Self\u2010expanding TAVR could be suitable for patients with extremely horizontal aortas after careful preoperative evaluation.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.30094","type":"journal-article","created":{"date-parts":[[2022,1,30]],"date-time":"2022-01-30T18:03:45Z","timestamp":1643565825000},"page":"1432-1439","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Self\u2010expanding transcatheter aortic valve replacement in patients with extremely horizontal aortas"],"prefix":"10.1002","volume":"99","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7815-9490","authenticated-orcid":false,"given":"Dao","family":"Zhou","sequence":"first","affiliation":[{"name":"Department of Cardiology Second Affiliated Hospital Zhejiang University School of Medicine Hangzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jun","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Cardiology Second Affiliated Hospital Zhejiang University School of Medicine Hangzhou 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