Abstract 19588: Correlation Between Aortic Angulation and Short and Long Term Outcomes Following TAVR

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Objectives: The aim of this study was to assess the correlation of increased aortic angulation (AA) on Immediate post procedural and Long-term outcomes following transcatheter aortic valve replacement (TAVR).

Background: There is limited data on the correlation of Aortic Angulation (AA) on short and long-term outcomes in patients undergoing TAVR. Few studies have suggested that increasing angulation will reduce procedural success in TAVR.

Methods: We assessed 139 patients who underwent TAVR at our institute and had Multislice computed tomography available for AA evaluation. TAVR endpoints, device success, and adverse events were considered according to the Valve Academic Research Consortium-2 definitions.

Results: The mean angulation of the aorta was 48.9 ± 9.6. Patients were divided into 2 groups: AA <49 and AA ≥49, and then further subdivided by Valve type. Patients with Balloon-Expandable valves whose AA was ≥49 had a higer 30 day mortality (p = 0.056), 6-month mortality (0.026) and 1 year mortality (0.055) compared to patients with AA <49. Pacemaker implantation rates were higher in patients with BE valves and AA ≥49 (p =0.9) and patients with SE valves and AA ≥49 (P =0.3) but did not reach significance. Post procedural Paravalvular leak, Major Bleeding and Balloon Valvuloplasty showed increasing trends in patients with AA ≥49 with both BE and SE valves.

Conclusions: Increased aortic root angulation negatively impacts short term procedural success and long term outcomes following SE and BE TAVR. In light of this, there must be careful selection of patients with high AA due to trends towards worse outcomes.

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