{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T06:08:25Z","timestamp":1778825305393,"version":"3.51.4"},"reference-count":36,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Prosthesis\u2010patient mismatch (PPM) remains common following transcatheter aortic valve replacement (TAVR) and is associated with worse clinical outcomes. PPM is of particular concern in small aortic annuli (SAA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To compare the incidence, predictors, and long\u2010term impact of PPM in SAA TAVR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Single\u2010center retrospective registry analysis of native, severe aortic stenosis patients with computed tomography\u2010derived annulus area \u2264\u2009430\u2009mm\u00b2, undergoing TAVR via transfemoral access. Significant PPM was defined as moderate and above and classified by the Valve Academic Research Consortium (VARC)\u20103. Additional analyses were conducted for predicted PPM and gender\u2010based criteria. Inverse probability treatment weighting (IPTW) was applied to identify predictors of significant PPM and long\u2010term mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The cohort included 631 consecutive patients with SAA undergoing TAVR between 2015 and 2024. Significant PPM occurred in 23.3%. Multivariable analyses identified BEV implantation (OR 2.1, 95% CI 1.3\u22124.9,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and larger body surface area (OR 4.6, 95% CI 1.7\u221218.8,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) as independent predictors of PPM. Large annulus perimeter had a protective association (OR 0.85, 95% CI 0.79\u22120.91,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Five\u2010year mortality was significantly higher among patients with significant PPM (32.0% vs. 25.4%; log\u2010rank\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.008). Age (HR 1.04, 95% CI 1.004\u22121.07,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.03), moderate and above paravalvular leak (HR 3.25, 95% CI 1.3\u22128.0,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01), and significant PPM (HR 1.97, 95% CI 1.2\u22123.1,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004) were independently associated with 5\u2010year mortality.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Significant PPM remains highly prevalent following SAA TAVR. BEV implantation and larger BSA were associated with significant PPM, and a larger implanted valve had a protective association. Significant PPM is independently associated with long\u2010term mortality.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ccd.70533","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T23:00:44Z","timestamp":1773010844000},"page":"1763-1773","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Long\u2010Term Impact of Prosthesis\u2010Patient Mismatch After Transcatheter Aortic Valve Replacement in Patients With Small Aortic Annuli"],"prefix":"10.1002","volume":"107","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5550-5490","authenticated-orcid":false,"given":"Itamar","family":"Loewenstein","sequence":"first","affiliation":[{"name":"Cardiology Department Tel Aviv Medical Center, Affiliated With the School of Medicine at Tel Aviv University Tel Aviv Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bar","family":"Gitter","sequence":"additional","affiliation":[{"name":"Cardiology Department Tel Aviv Medical Center, Affiliated With the School of Medicine at Tel Aviv University Tel Aviv Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tamar","family":"Itach","sequence":"additional","affiliation":[{"name":"Cardiology Department Tel Aviv Medical Center, Affiliated With the School of Medicine at Tel Aviv University Tel Aviv Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yaron","family":"Arbel","sequence":"additional","affiliation":[{"name":"Cardiology Department Tel Aviv Medical Center, Affiliated With the School of Medicine at Tel Aviv University Tel Aviv Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeremy","family":"Ben\u2010Shoshan","sequence":"additional","affiliation":[{"name":"Cardiology Department Tel Aviv Medical Center, Affiliated With the School of Medicine at Tel Aviv University Tel Aviv Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maayan","family":"Konigstein","sequence":"additional","affiliation":[{"name":"Cardiology Department Tel Aviv Medical Center, Affiliated With the School of Medicine at Tel Aviv University Tel Aviv Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ariel","family":"Finkelstein","sequence":"additional","affiliation":[{"name":"Cardiology Department Tel Aviv Medical Center, Affiliated With the School of Medicine at Tel Aviv University Tel Aviv Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amir","family":"Halkin","sequence":"additional","affiliation":[{"name":"Cardiology Department Tel Aviv Medical Center, Affiliated With the School of Medicine at Tel Aviv University Tel Aviv Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shmuel","family":"Banai","sequence":"additional","affiliation":[{"name":"Cardiology Department Tel Aviv Medical Center, Affiliated With the School of Medicine at Tel Aviv University Tel Aviv Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arie","family":"Steinvil","sequence":"additional","affiliation":[{"name":"Cardiology Department Tel Aviv Medical Center, Affiliated With the School of Medicine at Tel Aviv University Tel Aviv 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