High aortic angulation (AA) can pose significant challenges during TAVR. This meta-analysis determines the impact of a horizontal aorta on TAVR outcomes with balloon-expandable (BEV) and self-expanding valves (SEVs). A comprehensive search was conducted from inception to June 2024. Thirteen observational studies assessing the impact of aortic angulation in patients undergoing TAVR replacement were included. The pooled results indicated that short-term mortality was significantly lower in patients with a non-horizontal aorta . Subgroup analysis displayed that BEVs had a lower short-term mortality with a horizontal aorta than SEVs