{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T14:14:07Z","timestamp":1776348847479,"version":"3.51.2"},"reference-count":28,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2023,9,12]],"date-time":"2023-09-12T00:00:00Z","timestamp":1694476800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Extremely large aortic valve anatomy is one of the remaining limitations leading to exclusion of patients for transcatheter aortic valve replacement (TAVR).<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>The newly approved Myval 32\u2009mm device is designed for use in aortic annulus areas up to 840\u2009mm<jats:sup>2<\/jats:sup>. Here we want to share the initial worldwide experience with the device.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and Results<\/jats:title><jats:p>Retrospective data were collected from 10 patients with aortic stenosis and very large annular anatomy (mean area 765.5\u2009mm<jats:sup>2<\/jats:sup>), who underwent implantation with 32\u2009mm Myval\u00a0transcatheter heart valve at eight centers.\u00a0Valve Academic Research Consortium\u20102 device success was achieved in all cases. Mild paravalvular leak was observed in three patients and two patients required new pacemaker implantation. One patient experienced retroperitoneal hemorrhage caused by the contralateral 6\u2009F sheath and required surgical revision. No device\u2010related complications, stroke, or death from any cause occurred within the 30\u2010day follow\u2010up period. In a studied cohort of 2219 consecutive TAVR\u2010screened patients from a central European site, only 0.27% of patients showed larger anatomy than covered by the 32\u2009mm Myval device by\u00a0instructions for use without off\u2010label use of overexpansion. This rate was significantly higher for the 34\u2009mm Evolut Pro (1.8%) and 29\u2009mm Sapien 3 (2.1%) devices.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The Myval 32\u2009mm prosthesis showed promising initial results in a cohort of patients who previously had to be excluded from TAVR. It is desirable that all future TAVR systems accommodate larger anatomy to allow optimal treatment of all patients.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.30820","type":"journal-article","created":{"date-parts":[[2023,9,12]],"date-time":"2023-09-12T12:14:58Z","timestamp":1694520898000},"page":"1364-1375","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Performance of the 32\u2009mm Myval transcatheter heart valve for treatment of aortic stenosis in patients with extremely large aortic annuli in real\u2010world scenario: First global, multicenter experience"],"prefix":"10.1002","volume":"102","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1838-3033","authenticated-orcid":false,"given":"Andreas","family":"Holzamer","sequence":"first","affiliation":[{"name":"University of Regensburg Medical Center Regensburg 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