{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:56:08Z","timestamp":1782867368379,"version":"3.54.5"},"reference-count":24,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,11,30]],"date-time":"2023-11-30T00:00:00Z","timestamp":1701302400000},"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":[[2024,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Transcatheter aortic valve implantation (TAVI) using balloon\u2010expandable (BE) transcatheter heart valves (THV) in aortic annuli above 29\u2009mm includes particular procedural steps, mainly involving overfilling of the deployment balloon. Data on overfilling strategies in clinical daily practice is scarce. We herein aimed for a retrospective description of utilized overfilling strategies in those patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Between January 2016 and December 2022, 45 patients (100% male, 76.9\u2009\u00b1\u20096.1 years) received TAVI in aortic annuli above 29\u2009mm using a BE THV. Overfilling volumina of the deployment balloon were left to operators' discretion. Clinical and multislice computed tomography data were retrospectively collected. Clinical endpoints were adjudicated in accordance with the updated standardized VARC\u20103 definitions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Profound overfilling (+4\/5\u2009mL) was used in patients with a mild calcium burden (\u02c2750\u2009mm\u00b3) even in aortic annuli of 29.0\u201330.0\u2009mm. Nominal\/slight overfilling (+1\u2009mL) was used in aortic annuli up to 32.5\u2009mm but an intermediate to severe calcific burden (&gt;750\u20133200\u2009mm\u00b3). Accordingly, a low calcification group (\u02c2750\u2009mm\u00b3, <jats:italic>n<\/jats:italic>\u2009=\u200917) compared to a significant calcification group (\u2265750\u2009mm\u00b3, <jats:italic>n<\/jats:italic>\u2009=\u200928), presented with higher overfilling volumina (2.1\u2009\u00b1\u20091.4 vs. 0.8\u2009\u00b1\u20091.0; <jats:italic>p<\/jats:italic>\u2009\u02c2\u20090.001), although aortic annulus diameter was not different (29.8\u2009\u00b1\u20090.8 vs. 29.9\u2009\u00b1\u20090.9\u2009mm; <jats:italic>p<\/jats:italic>\u2009=\u20090.7). All\u2010cause 30\u2010day mortality was 0%. Device success was 97.8%. Transvalvular mean pressure gradient at discharge was 9.5\u2009\u00b1\u20093.6\u2009mmHg. No case of PVL &gt;mild was documented.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Extent of overfilling of the deployment balloon largely depends on calcification burden in addition to aortic annulus diameter with significant and profound overfilling particularly in patients with a calcification burden of the aortic valve complex \u02c2750\u2009mm\u00b3.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.30922","type":"journal-article","created":{"date-parts":[[2023,12,1]],"date-time":"2023-12-01T06:04:25Z","timestamp":1701410665000},"page":"194-201","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Balloon\u2010expandable transcatheter heart valves for treatment of aortic valve stenosis in patients with large aortic annuli: Evaluation of deployment balloon overfilling strategies"],"prefix":"10.1002","volume":"103","author":[{"given":"Yvonne","family":"Schneeberger","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Surgery University Heart and Vascular Center Hamburg Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harun","family":"Sarwari","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery University Heart and Vascular Center Hamburg Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benedikt","family":"K\u00f6ll","sequence":"additional","affiliation":[{"name":"Department of Cardiology University Heart and Vascular Center Hamburg Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Till J.","family":"Demal","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery University Heart and Vascular Center Hamburg Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oliver D.","family":"Bhadra","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery University Heart and Vascular Center Hamburg Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ina","family":"von der Heide","sequence":"additional","affiliation":[{"name":"Department of Cardiology University Heart and Vascular Center Hamburg Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Hannen","sequence":"additional","affiliation":[{"name":"Department of Cardiology University Heart and Vascular Center Hamburg Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Grundmann","sequence":"additional","affiliation":[{"name":"Department of Cardiology University Heart and Vascular Center Hamburg Hamburg 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