{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T07:32:07Z","timestamp":1770708727457,"version":"3.49.0"},"reference-count":20,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2021,5,13]],"date-time":"2021-05-13T00:00:00Z","timestamp":1620864000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100006520","name":"Edwards Lifesciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006520","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2021,11,15]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective\/Background<\/jats:title><jats:p>Small balloon expandable valves have higher echocardiographic transvalvular gradients and rates of prosthesis\u2010patient mismatch (PPM) compared to larger valves. However, the impact of these echocardiographic findings on clinical outcomes is unknown. We sought to determine the clinical outcomes of 20\u2009mm SAPIEN 3 (S3 BEV) compared to larger S3 BEV in relation to echocardiographic hemodynamics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Using the STS\/ACC transcatheter valve registry, we performed a propensity\u2010matched comparison of patients undergoing treatment of native aortic valve stenosis using transfemoral, balloon\u2010expandable implantation of 20\u2009mm and \u2265\u200923\u2009mm\u2009S3 BEVs. Baseline and procedure characteristics, echocardiographic variables and survival were analyzed. Multivariable logistic regression was used to identify predictors of 1\u2010year mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>After propensity matching of the 20\u2009mm and\u2009\u2265\u200923\u2009mm SAPIEN 3 valves, 3,931 pairs with comparable baseline characteristics were identified. Small valves were associated with significantly higher echocardiographic gradients at discharge (15.7\u2009\u00b1\u20097.1\u2009mmHg vs. 11.7\u2009\u00b1\u20095.5\u2009mmHg, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001) and severe PPM rates (21.5% vs. 9.7%, p\u2009&lt;\u20090.0001). There was no significant difference in 1\u2010year all\u2010cause mortality (20\u2009mm: 13.0% vs. \u226523\u2009mm: 12.7%, p\u00a0=\u00a00.72) or other major adverse event rates and outcomes between the two cohorts. Based on a multivariable analysis, elevated discharge mean gradient (&gt;20\u2009mmHg), severe PPM and the use of 20\u2009mm versus \u226523\u2009mm were not independent predictors of 1\u2010year mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>SAPIEN 3 20\u2009mm valves were associated with higher echocardiographic gradients, and severe PPM rates compared to larger valves but these factors were not associated with significant differences in 1\u2010year all\u2010cause mortality or rehospitalization.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.29756","type":"journal-article","created":{"date-parts":[[2021,5,13]],"date-time":"2021-05-13T17:38:58Z","timestamp":1620927538000},"page":"1185-1192","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Real world outcomes using 20\u2009mm balloon expandable <scp>SAPIEN<\/scp> 3\/ultra valves compared to larger valves (23, 26, and 29\u2009mm)\u2013a propensity matched analysis"],"prefix":"10.1002","volume":"98","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0334-6504","authenticated-orcid":false,"given":"Marvin H.","family":"Eng","sequence":"first","affiliation":[{"name":"Department of Medicine, Center for Structural Heart Disease Henry Ford Health System  Detroit Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amr E.","family":"Abbas","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Beaumont Health  Royal Oak Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rebecca T.","family":"Hahn","sequence":"additional","affiliation":[{"name":"New York\u2010Presbyterian\/Columbia University Irving Medical Center  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Medicine, Center for Structural Heart Disease Henry Ford Health System  Detroit Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5784-9924","authenticated-orcid":false,"given":"Dee Dee","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Medicine, Center for Structural Heart Disease Henry Ford Health System  Detroit Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6082-5379","authenticated-orcid":false,"given":"Mackram F.","family":"Eleid","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Mayo Clinic  Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William W.","family":"O'Neill","sequence":"additional","affiliation":[{"name":"Department of Medicine, Center for Structural Heart Disease Henry Ford Health System  Detroit Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,5,13]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.118.038408"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCINTERVENTIONS.114.001681"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2018.07.050"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2018.01.273"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2019.12.020"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2014.06.1195"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2017.05.031"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.119.044574"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.119.043785"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.119.043971"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.09.001"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCINTERVENTIONS.118.007396"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/ehjci\/jew025"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehs003"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2017.08.059"},{"key":"e_1_2_9_17_1","first-page":"56","article-title":"Invasive versus echocardiographic evaluation of Transvalvular gradients immediately post TAVR: demonstration of significant echocardiography\u2010catheterization discordance","volume":"93","author":"Abbas AE","year":"2019","journal-title":"Circ Cardiovasc Interv"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/echo.14663"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2018.07.028"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.01.054"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1093\/ehjci\/jev091"}],"container-title":["Catheterization and Cardiovascular 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