{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T02:10:29Z","timestamp":1740103829733,"version":"3.37.3"},"reference-count":19,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2022,9,24]],"date-time":"2022-09-24T00:00:00Z","timestamp":1663977600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Annular and left ventricular outflow tract (LVOT) calcification increase the risk of annular rupture following transcatheter aortic valve replacement (TAVR). The outcomes of a strategy of routine use of a balloon\u2010expandable valve (BEV) for all patients irrespective of annular or LVOT calcium is unknown.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>We evaluated the impact of bespoke sizing on annular rupture in patients treated with a BEV.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>All consecutive patients undergoing TAVR at a single centre (February 2020\u2013February 2022) were treated only with a BEV. No other valve design was used. Annular\/LVOT calcification was assessed using a standardized grading system. For each annular area, we determined the percentage valve oversizing with nominal deployment. The balloon deployment volume was then adjusted when required (over\u2010\/underfilled) to achieve over\u2010sizing of approximately 5% in the presence of annular\/LVOT calcium and 5%\u201310% in the absence of annular\/LVOT calcium. Adjusted valve areas were assumed to change proportionately to the change in balloon deployment volume.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 533 TAVR treated patients, annular\/LVOT calcification was present in 166 (31.1%) and moderate or severe in 90 (16.9%). In patients with annular\/LVOT calcification, the adjusted oversizing was 3.5\u2009\u00b1\u20093.6% and in patients without annular\/LVOT calcification, the adjusted oversizing was 6.8\u2009\u00b1\u20094.7% (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). There were no cases of annular rupture and no cases with more than mild paravalvular leak (PVL). Mild PVL was more frequent in patients with annular\/LVOT calcium (10.8% vs 4.6%, <jats:italic>p<\/jats:italic>\u2009=\u20090.01).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Bespoke BEV sizing by adjustment of balloon deployment volume avoided annular rupture in patients undergoing TAVR.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.30402","type":"journal-article","created":{"date-parts":[[2022,9,25]],"date-time":"2022-09-25T05:45:00Z","timestamp":1664084700000},"page":"823-831","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Bespoke valve sizing avoids annular rupture in patients treated with a balloon\u2010expandable transcatheter heart valve"],"prefix":"10.1002","volume":"100","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5539-9264","authenticated-orcid":false,"given":"Jorge","family":"Chavarria","sequence":"first","affiliation":[{"name":"Division of Cardiology, Hamilton Health Sciences McMaster University Hamilton Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Felipe","family":"Falcao","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Hamilton Health Sciences McMaster University Hamilton Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gustavo","family":"Dutra","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Hamilton Health Sciences McMaster University Hamilton Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9513-9440","authenticated-orcid":false,"given":"Janarthanan","family":"Sathananthan","sequence":"additional","affiliation":[{"name":"Centre for Cardiovascular Innovation, St. Paul's and Vancouver General Hospital University of British Columbia Vancouver British Columbia Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Wood","sequence":"additional","affiliation":[{"name":"Centre for Cardiovascular Innovation, St. Paul's and Vancouver General Hospital University of British Columbia Vancouver British Columbia Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Georgia","family":"Douvi","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Hamilton Health Sciences McMaster University Hamilton Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Madhu","family":"Natarajan","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Hamilton Health Sciences McMaster University Hamilton Canada"},{"name":"Population Health Research Institute Hamilton Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Iqbal","family":"Jaffer","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Hamilton Health Sciences McMaster University Hamilton Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James","family":"Velianou","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Hamilton Health Sciences McMaster University Hamilton Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tej","family":"Sheth","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Hamilton Health Sciences McMaster University Hamilton Canada"},{"name":"Population Health Research Institute Hamilton 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