{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,27]],"date-time":"2025-09-27T04:13:41Z","timestamp":1758946421324},"reference-count":10,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2016,10,14]],"date-time":"2016-10-14T00:00:00Z","timestamp":1476403200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2017,1]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>We present our single center experience with the direct flow medical (DFM) prosthesis addressing the impact of native aortic valve (AV) calcification degree on outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Background<\/jats:title><jats:p>The DFM\u00ae has been introduced for transcatheter aortic valve implantation (TAVI). The valve has a nonmetallic and inflatable support structure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients were divided in two groups according to preoperative cardiac computed tomography (CT): group I moderate calcification and group II heavy calcification of the total AV area. We evaluated 118 patients: 53 (45%) group I and 65 (55%) group II.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Preoperative trans\u2010AV gradient and calcification extension across the aortic unit were significantly higher in group II (<jats:italic>P<\/jats:italic>\u2009=\u20090.008 and <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.0001). CT perimeter derived annular diameter (group I 24.7\u2009\u00b1\u20092.1 mm vs. group II 24.8\u2009\u00b1\u20091.9; <jats:italic>P<\/jats:italic>\u2009=\u20090.6) and implanted prosthesis size (group I 26.1\u2009\u00b1\u20091.5 mm vs. group II 25.7\u2009\u00b1\u20091.5; <jats:italic>P<\/jats:italic>\u2009=\u20090.1) were similar. Hemodynamics were similar: mean gradient 16.1\u2009\u00b1\u20095.9 mm Hg (group I) vs. 17.3\u2009\u00b1\u20096.5 mm Hg (group II) (<jats:italic>P<\/jats:italic>\u2009=\u20090.3). Total aortic regurgitation (AR) was mild in 5.7% in group I and 20% in group II (<jats:italic>P<\/jats:italic>\u2009=\u20090.03). None developed moderate\/severe AR. Heavy AV calcification was the sole independent determinant for mild regurgitation (<jats:italic>P<\/jats:italic>\u2009=\u20090.02; OR\u2009=\u20097; 95% CI: 1.2\u201337.6). Follow\u2010up (289 days; 40\u2013760 days) estimated survival was 88.1% (group I) and 93.8% (group II) (<jats:italic>P<\/jats:italic>\u2009=\u20090.3).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Independent of AV calcification degree, adequate sizing and implantation can be achieved with the DFM\u00ae. Although higher burden of calcification increases the rate of mild AR, no patient developed moderate and severe AR. Short\u2010term estimated survival was not influenced by calcification degree. \u00a9 2016 Wiley Periodicals, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.26517","type":"journal-article","created":{"date-parts":[[2016,10,14]],"date-time":"2016-10-14T08:19:20Z","timestamp":1476433160000},"page":"135-142","source":"Crossref","is-referenced-by-count":2,"title":["Transcatheter aortic valve implantation with the direct flow medical prosthesis: Impact of native aortic valve calcification degree on outcomes"],"prefix":"10.1002","volume":"89","author":[{"given":"Giuseppe","family":"D'Ancona","sequence":"first","affiliation":[{"name":"Department of Cardiology Vivantes Klinikum im Friedrichshain und Am Urban, Berlin, Germany"},{"name":"Heart Center, Rostock University Medical Center Rostock Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H\u00fcseyin U.","family":"Agma","sequence":"additional","affiliation":[{"name":"Department of Cardiology Vivantes Klinikum im Friedrichshain und Am Urban, Berlin, Germany"},{"name":"Heart Center, Rostock University Medical Center Rostock Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H\u00fcseyin","family":"Ince","sequence":"additional","affiliation":[{"name":"Department of Cardiology Vivantes Klinikum im Friedrichshain und Am Urban, Berlin, Germany"},{"name":"Heart Center, Rostock University Medical Center Rostock Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gihan","family":"El\u2010Achkar","sequence":"additional","affiliation":[{"name":"Department of Cardiology Vivantes Humboldt\u2010Klinikum Berlin Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Di\u00dfmann","sequence":"additional","affiliation":[{"name":"Department of Cardiology Vivantes Humboldt\u2010Klinikum Berlin Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jasmin","family":"Ortak","sequence":"additional","affiliation":[{"name":"Department of Cardiology Vivantes Klinikum im Friedrichshain und Am Urban, Berlin, Germany"},{"name":"Heart Center, Rostock University Medical Center Rostock Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephan","family":"Kische","sequence":"additional","affiliation":[{"name":"Department of Cardiology Vivantes Klinikum im Friedrichshain und Am Urban, Berlin, Germany"},{"name":"Heart Center, Rostock University Medical Center Rostock Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,10,14]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2012.09.002"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.4244\/EIJV10I3A66"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.10.013"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.04.036"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2251011703"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.06.0232"},{"key":"e_1_2_8_8_1","doi-asserted-by":"crossref","first-page":"500","DOI":"10.1002\/ccd.26039","article-title":"Transcatheter, inflatable, and fully repositionable aortic valve: Preliminary results using a modified implantation technique","volume":"87","author":"S Kische","year":"2015","journal-title":"Catheter Cardiovasc 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