Thanks to newer heart valves, aortic angulation no longer affects TAVR outcomes
Aortic angulation (AA) is not associated with worse transcatheter aortic valve replacement (TAVR) outcomes when clinicians use newer-generation heart valves, according to new findings published in JACC: Cardiovascular Interventions.
With older transcatheter heart valves (THVs), the study’s authors noted, AA ≥48° was associated with lower procedural success rates and worse in-hospital outcomes. This was especially true for self-expanding THVS. But would that still be true with the most recent generation of THVs? First author Giorgio A. Medranda, MD, a specialist at MedStar Washington Hospital, and colleagues tracked data from more than 800 patients to find out.
All patients underwent TAVR with the balloon-expandable (BE) Sapien 3 from Edwards Lifesciences or the SE CoreValve Evolut Pro from Medtronic at a single high-volume facility. “Baseline clinical, echocardiographic, procedural, and in-hospital details” were assessed for each patient. If an individual underwent valve-in-valve TAVR, or no pre-TAVR CT results were available, they were excluded from this analysis.
Overall, the authors determined that AA ≥48° was no longer associated with a negative impact on patient outcomes when using these updated BE and SE THVs. They attributed this change to both advances in THV technology and “ongoing refinements in TAVR implantation techniques.”
“AA should no longer be a consideration when determining THV selection,” Medranda et al. concluded.
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Michael has more than 18 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.