{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T22:07:43Z","timestamp":1791410863266,"version":"4.3.3"},"reference-count":20,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2015,10,26]],"date-time":"2015-10-26T00:00:00Z","timestamp":1445817600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Heart Center Freiburg University"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2016,3]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Aortic annulus rupture is a rare, but potentially fatal complication of transcatheter aortic valve replacement (TAVR), especially when it occurs by balloon\u2010expandable devices. In order to improve the predictability of procedures and avoid ruptures we investigated whether or not the aortic root volume measures is a useful indicator of risk, and if it could be useful for the prosthesis size selection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and Results<\/jats:title><jats:p>From a retrospective series of 172 TAVR patients, seven experienced contained aortic annulus ruptures. The receiver operating curves were used to illustrate sensitivity and specificity of the different aortic annulus size and aortic root volume measures. The annulus area oversizing of \u226520% resulted in a sensitivity of 100%, specificity of 55.76%, and positive predictive value (PPV) of 8.75%. In patients receiving 26mm prostheses, the aortic root volume (ARV &lt;13600mm<jats:sup>3<\/jats:sup>) provided a better specificity and PPV (79.63 and 18.52%, respectively). A two\u2010step testing procedure considering the area derived average annulus diameter (<jats:italic>D<\/jats:italic><jats:sub>area<\/jats:sub> &lt;23mm) as a first separating parameter and then the ARV (&lt;13,600mm<jats:sup>3<\/jats:sup>) as a further indicator showed the most promising results with the PPV of 31.25%. Regardless of the procedure steps no false negative results were predicted.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our data show that the ARV provides a better predictive value for correct prosthesis sizing than established annulus measurements, especially in \u2018borderline\u2019 annuli. We suggest a two\u2010step testing procedure for prostheses size selection, considering <jats:italic>D<\/jats:italic><jats:sub>area<\/jats:sub> and ARV to minimize the risk of annulus rupture. Prospective studies and examination of larger datasets are warranted to confirm these findings. \u00a9 2015 Wiley Periodicals, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.26260","type":"journal-article","created":{"date-parts":[[2015,10,26]],"date-time":"2015-10-26T13:46:48Z","timestamp":1445867208000},"page":"807-817","source":"Crossref","is-referenced-by-count":6,"title":["Aortic root volume is associated with contained rupture of the aortic annulus in balloon\u2010expandable transcatheter aortic valve replacement"],"prefix":"10.1002","volume":"87","author":[{"given":"Jochen","family":"Rein\u00f6hl","sequence":"first","affiliation":[{"name":"Heart Center Freiburg University, Department of Cardiology and Angiology I  Freiburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dimitrios","family":"Psyrakis","sequence":"additional","affiliation":[{"name":"Heart Center Freiburg University, Department of Cardiology and Angiology I  Freiburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klaus","family":"Kaier","sequence":"additional","affiliation":[{"name":"Heart Center Freiburg University, Department of Cardiology and Angiology I  Freiburg, Germany"},{"name":"Institute of Medical Biometry and Informatics Medical Center, University of Freiburg  Freiburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sodikdjon","family":"Kodirov","sequence":"additional","affiliation":[{"name":"Almazov Federal Heart Blood and Endocrinology Centre Saint Petersburg Russia"},{"name":"Morehouse School of Medicine Neuroscience Institute Atlanta Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Siepe","sequence":"additional","affiliation":[{"name":"Heart Center Freiburg University, Department of Cardiology and Angiology I  Freiburg, 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Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregor","family":"Pache","sequence":"additional","affiliation":[{"name":"Department of Radiology, Center for Diagnostic and Therapeutic Radiology University Hospital Freiburg  Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Zirlik","sequence":"additional","affiliation":[{"name":"Heart Center Freiburg University, Department of Cardiology and Angiology I  Freiburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathias","family":"Langer","sequence":"additional","affiliation":[{"name":"Department of Radiology, Center for Diagnostic and Therapeutic Radiology University Hospital Freiburg  Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Friedhelm","family":"Beyersdorf","sequence":"additional","affiliation":[{"name":"Heart Center Freiburg University, Department of Cardiology and Angiology I  Freiburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manfred","family":"Zehender","sequence":"additional","affiliation":[{"name":"Heart Center Freiburg University, Department of Cardiology and Angiology I  Freiburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"Bode","sequence":"additional","affiliation":[{"name":"Heart Center Freiburg University, Department of Cardiology and Angiology I  Freiburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philipp","family":"Blanke","sequence":"additional","affiliation":[{"name":"Department of Radiology, Center for Diagnostic and Therapeutic Radiology University Hospital Freiburg  Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,10,26]]},"reference":[{"key":"e_1_2_8_2_1","first-page":"49","article-title":"Congenital aneurysm of the aortic sinus of 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