{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T17:49:47Z","timestamp":1790704187614,"version":"4.1.0"},"reference-count":22,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2023,9,5]],"date-time":"2023-09-05T00:00:00Z","timestamp":1693872000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Preprocedural computed tomography planning improves procedural safety and efficacy of transcatheter aortic valve implantation (TAVI). However, contemporary imaging modalities do not account for device\u2010host interactions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>This study evaluates the value of preprocedural computer simulation with FEops HEARTguide<jats:sup>TM<\/jats:sup> on overall device success in patients with challenging anatomies undergoing TAVI with a contemporary self\u2010expanding supra\u2010annular transcatheter heart valve.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This prospective multicenter observational study included patients with a challenging anatomy defined as bicuspid aortic valve, small annulus or severely calcified aortic valve. We compared the heart team's transcatheter heart valve (THV) planning decision based on (1) conventional multislice computed tomography (MSCT) and (2) MSCT imaging with FEops HEARTguide<jats:sup>TM<\/jats:sup> simulations. Clinical outcomes and THV performance were followed up to 30 days.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 77 patients were included (median age 79.9 years (IQR 74.2\u201383.8), 42% male). In 35% of the patients, preprocedural planning changed after FEops HEARTguide<jats:sup>TM<\/jats:sup> simulations (change in valve size selection [12%]\u00a0or target implantation height [23%]). A new permanent pacemaker implantation (PPI) was implanted in 13% and &gt;trace paravalvular leakage (PVL) occurred in 28.5%. The contact pressure index (i.e., simulation output indicating the risk of conduction abnormalities) was significantly higher in patients with a new PPI, compared to those without (16.0% [25th\u201375th percentile 12.0\u201321.0]\u00a0vs. 3.5% [25th\u201375th percentile 0\u201311.3], <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01) The predicted PVL was 5.7\u2009mL\/s (25th\u201375th percentile 1.3\u201311.1) in patients with none\u2010trace PVL, 12.7 (25th\u201375th percentile 5.5\u201319.1) in mild PVL and 17.7 (25th\u201375th percentile 3.6\u201319.4) in moderate PVL\u00a0(<jats:italic>p<\/jats:italic>\u2009=\u20090.04).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>FEops HEARTguide<jats:sup>TM<\/jats:sup> simulations may provide enhanced insights in the risk for PVL or PPI after TAVI with a self\u2010expanding supra\u2010annular THV in complex anatomies.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.30816","type":"journal-article","created":{"date-parts":[[2023,9,5]],"date-time":"2023-09-05T09:59:26Z","timestamp":1693907966000},"page":"1140-1148","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Clinical value of CT\u2010derived simulations of transcatheter\u2010aortic\u2010valve\u2010implantation in challenging anatomies the PRECISE\u2010TAVI trial"],"prefix":"10.1002","volume":"102","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9309-0011","authenticated-orcid":false,"given":"Thijmen W.","family":"Hokken","sequence":"first","affiliation":[{"name":"Department of Cardiology Thoraxcenter, Erasmus University Medical Center Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5810-2868","authenticated-orcid":false,"given":"Hendrik","family":"Wienemann","sequence":"additional","affiliation":[{"name":"Clinic III for Internal Medicine, Faculty of Medicine and University Hospital Cologne Cologne Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Dargan","sequence":"additional","affiliation":[{"name":"Cardiology Clinical Academic Group St. George's University of London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dirk\u2010Jan\u00a0van","family":"Ginkel","sequence":"additional","affiliation":[{"name":"Department of Cardiology St. Antonius Hospital Nieuwegein The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cameron","family":"Dowling","sequence":"additional","affiliation":[{"name":"MonashHeart, Monash Health and Vascular Surgery, Monash Cardiovascular Research Centre Monash University Melbourne Victoria Australia"},{"name":"Stanford University School of Medicine,\u00a0Division of Cardiovascular Medicine Stanford California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Axel","family":"Unbehaun","sequence":"additional","affiliation":[{"name":"Department of Cardiology German Heart Center Berlin Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johan","family":"Bosmans","sequence":"additional","affiliation":[{"name":"Department of Cardiology Antwerp University Hospital Antwerp Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Bader\u2010Wolfe","sequence":"additional","affiliation":[{"name":"Department of Cardiology German Heart Center Berlin Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Gooley","sequence":"additional","affiliation":[{"name":"MonashHeart, Monash Health and Vascular Surgery, Monash Cardiovascular Research Centre Monash University Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Swaans","sequence":"additional","affiliation":[{"name":"Department of Cardiology St. Antonius Hospital Nieuwegein The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen J.","family":"Brecker","sequence":"additional","affiliation":[{"name":"Cardiology Clinical Academic Group St. George's University of London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matti","family":"Adam","sequence":"additional","affiliation":[{"name":"Clinic III for Internal Medicine, Faculty of Medicine and University Hospital Cologne Cologne Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2732-1205","authenticated-orcid":false,"given":"Nicolas M.","family":"Van Mieghem","sequence":"additional","affiliation":[{"name":"Department of Cardiology Thoraxcenter, Erasmus University Medical Center Rotterdam The 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