{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T13:20:22Z","timestamp":1762867222172,"version":"3.37.3"},"reference-count":10,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2017,8,24]],"date-time":"2017-08-24T00:00:00Z","timestamp":1503532800000},"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":[[2018,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To evaluate overexpanded 29 mm SAPIEN (S3) transcatheter heart valves in patients with aortic annuli area &gt;683 mm<jats:sup>2<\/jats:sup>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Background<\/jats:title><jats:p>The largest valve area the 29 mm S3 is specified for is 683 mm<jats:sup>2<\/jats:sup>. Valve overexpansion has been performed in patients with larger aortic annuli, but data are limited. Moreover, feasibility in areas &gt;740 mm<jats:sup>2<\/jats:sup> is unknown.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>All 29 mm S3 transcatheter aortic valve replacements (TAVR) at a single center over 23\u2010months were retrospectively reviewed. Patients with annulus areas &gt;683 mm<jats:sup>2<\/jats:sup> were included. Immediate post\u2010TAVR hemodynamics and transthoracic echocardiography (TTE) findings on post\u2010TAVR day\u20101 and day\u201030 were recorded.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 81 29 mm S3 TAVR cases, 3 (3.7%) met inclusion criteria (patients 1, 2, and 3 had CT\u2010scan derived areas of 748.1 mm<jats:sup>2<\/jats:sup>, 793 mm<jats:sup>2<\/jats:sup>, and 787 mm<jats:sup>2<\/jats:sup>, respectively). Annular eccentricity index ranged from 0.12 to 0.25. All underwent transfemoral TAVR with 29 mm S3 valves overexpanded using +4 mL of contrast. Post\u2010dilatation with +5 mL was performed in patient 2. The average valve shortening was 10.68 mm. On day 1, patients 1 and 2 had trace and mild paravalvular leak (PVL) (respectively), whereas, patient 3 had mild\u2013moderate PVL. Patient 1 was also noted to have trace central AR on day 1. No other central AR was noted. Immediate post\u2010procedure aortic regurgitation (AR) index in patients 1, 2, and 3 was 43, 34, and 33 respectively. At 30 days, AR was completely resolved in patient 1, whereas AR severity in patients 2 and 3 remained similar. No patients had\u2009&gt;\u2009moderate AR at any point during follow\u2010up. No valve migration or embolization occurred. Patient 1 required a permanent pacemaker. No other major complications were noted. All patients were clinically stable at 30 days.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>TAVR using overexpanded 29 mm S3 in valve areas &gt;740 mm<jats:sup>2<\/jats:sup> (up to 793 mm<jats:sup>2<\/jats:sup>) seemed to be safe and feasible in our small series. Further study in a larger series is needed to determine clinical outcomes in this patient population.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.27190","type":"journal-article","created":{"date-parts":[[2017,8,24]],"date-time":"2017-08-24T08:44:48Z","timestamp":1503564288000},"page":"1149-1156","source":"Crossref","is-referenced-by-count":14,"title":["Overexpansion of the 29 mm <scp>SAPIEN<\/scp> 3 transcatheter heart valve in patients with large aortic annuli (area &gt;\u2009683 mm<sup>2<\/sup>): A case series"],"prefix":"10.1002","volume":"91","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1673-2404","authenticated-orcid":false,"given":"Moses","family":"Mathur","sequence":"first","affiliation":[{"name":"Department of Medicine, Division of Cardiology University of Washington Seattle Washington"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0452-2327","authenticated-orcid":false,"given":"James M.","family":"McCabe","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Cardiology University of Washington Seattle Washington"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriel","family":"Aldea","sequence":"additional","affiliation":[{"name":"Division of Cardiothoracic Surgery, Department of Surgery University of Washington Seattle Washington"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jay","family":"Pal","sequence":"additional","affiliation":[{"name":"Division of Cardiothoracic Surgery, Department of Surgery University of Washington Seattle Washington"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Creighton W.","family":"Don","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Cardiology University of Washington Seattle Washington"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,8,24]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehs109"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2014.02.536"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)30073-3"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2015.10.006"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2011.12.015"},{"key":"e_1_2_8_7_1","first-page":"190","article-title":"Relationship of aortic annular eccentricity and paravalvular regurgitation post transcatheter aortic valve implantation with CoreValve","volume":"25","author":"Wong D","year":"2013","journal-title":"J Invasive Cardiol"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2014.10.014"},{"key":"e_1_2_8_9_1","unstructured":"Medtronic Press Release: Medtronic Announces FDA Approval of New Recaptureable TAVR System Available for Severe Aortic Stenosis Patients with Large Anatomies. Available at:http:\/\/newsroom.medtronic.com\/phoenix.zhtml?c=251324&p=irol-newsArticle&ID= 2216121. Accessed November 17 2016."},{"key":"e_1_2_8_10_1","unstructured":"American College of Cardiology Expert Analysis: Risk Stratification for Pacemaker Placement After TAVR. Available at:http:\/\/www.acc.org\/latest-in-cardiology\/articles\/2016\/04\/26\/15\/22\/risk-stratification-for-pacemaker-placement-after-tavr. Accessed February 21 2017."},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2015.12.023"}],"container-title":["Catheterization and Cardiovascular Interventions"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fccd.27190","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccd.27190","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,23]],"date-time":"2023-09-23T22:20:03Z","timestamp":1695507603000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccd.27190"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,8,24]]},"references-count":10,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2018,5]]}},"alternative-id":["10.1002\/ccd.27190"],"URL":"https:\/\/doi.org\/10.1002\/ccd.27190","archive":["Portico"],"relation":{},"ISSN":["1522-1946","1522-726X"],"issn-type":[{"type":"print","value":"1522-1946"},{"type":"electronic","value":"1522-726X"}],"subject":[],"published":{"date-parts":[[2017,8,24]]}}}