{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T13:16:19Z","timestamp":1787318179037,"version":"build-2736575974"},"reference-count":28,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Interventions"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>An increased degree of aortic angulation (AA) represents a challenging feature for bioprosthesis positioning. Whether AA has an impact on procedural outcomes of contemporary self-expanding valves remains unsettled. The aim of this study was to evaluate the impact of AA on procedural outcomes of transcatheter aortic valve replacement with contemporary self-expanding valves.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>The HORSE (Horizontal Aorta in Transcatheter Self-Expanding Valves) is an international, retrospective registry including 3862 consecutive patients undergoing transcatheter aortic valve replacement with either Evolut R\/PRO (n=1959) or ACURATE neo (n=1903) devices. Patients undergoing Evolut R 34 mm implantation were excluded as no comparable prosthesis size for ACURATE neo is available. AA was evaluated with preprocedural computed tomography, and its impact on device success was evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      In the overall population, AA did not have any impact upon device success, also when adjusting for in-study outcome predictors (odds ratio for 1\u00b0 increment, 0.99 [95% CI, 0.98\u20131.01],\n                      <jats:italic>P<\/jats:italic>\n                      =0.306). However, increased AA was associated with lower device success with use of the Evolut R\/PRO valves (odds ratio, 0.97 [95% CI, 0.95\u20130.99];\n                      <jats:italic>P<\/jats:italic>\n                      =0.004), but not the ACURATE neo valves (odds ratio, 1.00 [95% CI, 0.98\u20131.03],\n                      <jats:italic>P<\/jats:italic>\n                      =0.304). The best AA cutoff value predicting device success was 49\u00b0 (47% of the study cohort). Among patients with AA\u226549\u00b0, Evolut R\/PRO valves were associated with lower device success as compared to the ACURATE neo valve (inverse probability weighting odds ratio, 0.62 [95% CI, 0.46\u20130.83];\n                      <jats:italic>P<\/jats:italic>\n                      =0.002).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Horizontal aorta, as defined by an AA \u226549\u00b0, is a common feature among transcatheter aortic valve replacement candidates and predicts device failure of the Evolut R\/PRO valves, but not of the ACURATE neo valve. AA may be an effect modifier of the association between self-expanding valve type and device success.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circinterventions.121.010641","type":"journal-article","created":{"date-parts":[[2021,8,30]],"date-time":"2021-08-30T05:00:10Z","timestamp":1630299610000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":38,"title":["Horizontal Aorta in Transcatheter Self-Expanding Valves: Insights From the HORSE International Multicentre Registry"],"prefix":"10.1161","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2293-8270","authenticated-orcid":true,"given":"Francesco","family":"Gallo","sequence":"first","affiliation":[{"name":"Interventional Cardiology Unit, GVM Care and Research Maria Cecilia Hospital (F.G., A.M., A.K., A.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8011-6844","authenticated-orcid":true,"given":"Guglielmo","family":"Gallone","sequence":"additional","affiliation":[{"name":"Azienda Ospedaliera Universitaria Citt\u00e0 della Salute e della Scienza di Torino, Turin, Italy (G.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0799-7478","authenticated-orcid":true,"given":"Won-Keun","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany (W.-K.K., J.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3414-2969","authenticated-orcid":true,"given":"J\u00f6rg","family":"Reifart","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany (W.-K.K., J.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2744-2154","authenticated-orcid":true,"given":"Verena","family":"Veulemans","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Pulmonology and Vascular Medicine, Heinrich Heine University, D\u00fcsseldorf, Germany (V.V., T.Z.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4517-0068","authenticated-orcid":true,"given":"Tobias","family":"Zeus","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Pulmonology and Vascular Medicine, Heinrich Heine University, D\u00fcsseldorf, Germany (V.V., T.Z.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7860-0298","authenticated-orcid":true,"given":"Stefan","family":"Toggweiler","sequence":"additional","affiliation":[{"name":"Cantonal Hospital Lucerne, Switzerland (S.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ole","family":"De Backer","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The Heart Centre, Rigshospitalet, Copenhagen University Hospital, Denmark (O.D.B., L.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars","family":"S\u00f8ndergaard","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The Heart Centre, Rigshospitalet, Copenhagen University Hospital, Denmark (O.D.B., L.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Mangieri","sequence":"additional","affiliation":[{"name":"Interventional Cardiology Unit, GVM Care and Research Maria Cecilia Hospital (F.G., A.M., A.K., A.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4455-2865","authenticated-orcid":true,"given":"Arif","family":"Khokhar","sequence":"additional","affiliation":[{"name":"Interventional Cardiology Unit, GVM Care and Research Maria Cecilia Hospital (F.G., A.M., A.K., A.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico","family":"De Marco","sequence":"additional","affiliation":[{"name":"Department of Clinical and Interventional Cardiology, IRCCS Policlinico San Donato, San Donato Milanese, Italy (F.D.M., R.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Damiano","family":"Regazzoli","sequence":"additional","affiliation":[{"name":"Humanitas Clinical and Research Center\u2013IRCCS, Rozzano-Milano, Italy (D.R., B.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernhard","family":"Reimers","sequence":"additional","affiliation":[{"name":"Humanitas Clinical and Research Center\u2013IRCCS, Rozzano-Milano, Italy (D.R., B.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guillem","family":"Muntan\u00e9-Carol","sequence":"additional","affiliation":[{"name":"Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada (G.M.-C., J.R.-C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodrigo","family":"Est\u00e9vez-Loureiro","sequence":"additional","affiliation":[{"name":"Interventional Cardiology Unit, Hospital \u00c1lvaro Cunqueiro, Vigo, Spain (R.E.-L., A.E.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9749-0880","authenticated-orcid":true,"given":"Antonio","family":"Espino","sequence":"additional","affiliation":[{"name":"Interventional Cardiology Unit, Hospital \u00c1lvaro Cunqueiro, Vigo, Spain (R.E.-L., 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