{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T14:40:11Z","timestamp":1758897611915,"version":"3.44.0"},"reference-count":19,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,12,24]],"date-time":"2024-12-24T00:00:00Z","timestamp":1734998400000},"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":[[2025,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The management of Transcatheter Aortic Valve Implantation (TAVI) patients with a small aortic annulus (SAA) postures a substantial challenge, increasing the risk of patient\u2010 prosthesis mismatch (PPM) and overall mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>This study aimed to compare the hemodynamic and clinical outcomes of transcatheter balloon\u2010expandable valve (BEV) versus transcatheter self\u2010expandable valve (SEV) in SAA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted propensity score matching (PSM) of severe AS patients with SAA who underwent trans\u2010femoral TAVR and enrolled to the Israeli TAVR registry between the years 2008 and 2023. SAA was defined as an aortic\u2010valve annulus area\u2009\u2264\u2009430\u2009mm<jats:sup>2<\/jats:sup>. Since the BEV used have a smaller size cut\u2010off, an additional analysis on very small aortic annulus (vSAA) as defined as aortic\u2010valve annulus area\u2009\u2264\u2009345\u2009mm<jats:sup>2<\/jats:sup> was performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The study included 1364 consecutive patients with SAA of (BEV <jats:italic>n<\/jats:italic>\u2009=\u2009485; SEV <jats:italic>n\u2009<\/jats:italic>=\u2009879) at a mean age of 82\u2009\u00b1\u20097 years, of whom the vast majority were female (83%). Propensity\u2010matched groups comprised of 329 and 122 paired for the SAA and vSAA patients, respectively. As compared to BEV in the SAA and vSAA analyses, SEV showed lower rates of postprocedural of LBBB (32% vs. 22% and 41% vs. 22%; both <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01, respectively), however, higher rates of major vascular complications (2% vs. 7% and 2% vs. 12%; both <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01, respectively) and major or life\u2010threatening bleeding but only in vSAA group (17% vs. 9.1%, <jats:italic>p<\/jats:italic>\u2009=\u20090.009). One\u2010month mortality was higher in the SEV versus BEV in both SAA and vSAA comparisons (2% vs. 0.6%, <jats:italic>p<\/jats:italic>\u2009=\u20090.048 and 3% vs. 0%, <jats:italic>p<\/jats:italic>\u2009=\u20090.018; respectively). A nonsignificant trend of higher 5\u2010year mortality was observed in univariate models, noted mainly in vSAA patients (22% vs. 19%, <jats:italic>p<\/jats:italic>\u2009=\u20090.385; 24% vs. 15%, <jats:italic>p<\/jats:italic>\u2009=\u20090.073).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The present analysis observed higher rates of major vascular complications and 1\u2010month mortality in SAA and vSAA treated with SEV. A similar nonsignificant trend toward long\u2010term mortality for the vSAA group was observed and should be evaluated in larger cohorts.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.31374","type":"journal-article","created":{"date-parts":[[2024,12,24]],"date-time":"2024-12-24T07:09:42Z","timestamp":1735024182000},"page":"624-632","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Transcatheter Aortic Valve Implantation in Small and Very Small Aortic Valve Annuli: A Propensity\u2010Matched Analysis Between Self\u2010Expanding Versus Balloon\u2010Expandable Valves"],"prefix":"10.1002","volume":"105","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7419-0631","authenticated-orcid":false,"given":"Tamar","family":"Itach","sequence":"first","affiliation":[{"name":"Cardiology Department Tel Aviv Sourasky Medical Center Tel Aviv Israel"},{"name":"Affiliated to Sackler School of Medicine Tel Aviv University Tel Aviv Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Itamar","family":"Loewenstein","sequence":"additional","affiliation":[{"name":"Cardiology Department Tel Aviv Sourasky Medical Center Tel Aviv Israel"},{"name":"Affiliated to Sackler School of Medicine Tel Aviv University Tel Aviv Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Zahler","sequence":"additional","affiliation":[{"name":"Cardiology Department Tel Aviv Sourasky Medical Center Tel Aviv Israel"},{"name":"Affiliated to Sackler School of Medicine Tel Aviv University Tel Aviv Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ariel","family":"Finkelstein","sequence":"additional","affiliation":[{"name":"Cardiology Department Tel Aviv Sourasky Medical Center Tel Aviv Israel"},{"name":"Affiliated to Sackler School of Medicine Tel Aviv University Tel Aviv Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Israel","family":"Barbash","sequence":"additional","affiliation":[{"name":"Affiliated to Sackler School of Medicine Tel Aviv University Tel Aviv Israel"},{"name":"Leviev Heart Center, Chaim Sheba Medical Center Ramat Gan Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabby Elbaz","family":"Greener","sequence":"additional","affiliation":[{"name":"Cardiology Department Hadassah Medical Center Jerusalem Israel"},{"name":"Hebrew University of Jerusalem Jerusalem Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hana","family":"Assa\u2010Vaknin","sequence":"additional","affiliation":[{"name":"Affiliated to Sackler School of Medicine Tel Aviv University Tel Aviv Israel"},{"name":"Cardiology Department Rabin Medical Center Petach Tikva Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7708-8253","authenticated-orcid":false,"given":"Ran","family":"Kornowski","sequence":"additional","affiliation":[{"name":"Affiliated to Sackler School of Medicine Tel Aviv University Tel Aviv Israel"},{"name":"Cardiology Department Rabin Medical Center Petach Tikva Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Turyan","sequence":"additional","affiliation":[{"name":"Hebrew University of Jerusalem Jerusalem Israel"},{"name":"Cardiology Department Sha'arei Zedek Medical Center Jerusalem Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arie","family":"Steinvil","sequence":"additional","affiliation":[{"name":"Cardiology Department Tel Aviv Sourasky Medical Center Tel Aviv Israel"},{"name":"Affiliated to Sackler School of Medicine Tel Aviv University Tel Aviv Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,12,24]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2015.02.007"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.118.038408"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.123.067326"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2021.03.060"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCINTERVENTIONS.117.005013"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2019.08.041"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2016.11.044"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1056\/nejmoa2312573"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000923"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2017.06.026"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.4244\/eij-d-18-00552"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2014.06.1195"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2008.09.022"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2012.09.002"},{"issue":"10","key":"e_1_2_9_16_1","first-page":"613","article-title":"Transcatheter Aortic Valve Implantation: A Single\u2010Center Experience of 300 Cases","volume":"15","author":"Finkelstein A.","year":"2013","journal-title":"The Israel Medical Association Journal: IMAJ"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacasi.2022.06.002"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2015.0326"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2018.07.050"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1056\/nejmoa1400590"}],"container-title":["Catheterization and Cardiovascular Interventions"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccd.31374","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T14:24:45Z","timestamp":1758896685000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccd.31374"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,24]]},"references-count":19,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2025,2]]}},"alternative-id":["10.1002\/ccd.31374"],"URL":"https:\/\/doi.org\/10.1002\/ccd.31374","archive":["Portico"],"relation":{},"ISSN":["1522-1946","1522-726X"],"issn-type":[{"type":"print","value":"1522-1946"},{"type":"electronic","value":"1522-726X"}],"subject":[],"published":{"date-parts":[[2024,12,24]]},"assertion":[{"value":"2024-07-30","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-12-07","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-12-24","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}