{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T13:10:38Z","timestamp":1789650638897,"version":"4.0.0"},"reference-count":30,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T00:00:00Z","timestamp":1789603200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T00:00:00Z","timestamp":1789603200000},"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"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Patients with small aortic annuli undergoing transcatheter aortic valve implantation (TAVI) are at risk of higher residual transvalvular gradients. Evidence on the performance of new\u2010generation intra\u2010annular self\u2010expanding valves in this anatomical setting remains limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To evaluate the impact of annular size on procedural, hemodynamic, and mid\u2010term clinical outcomes after TAVI with the Navitor valve.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Patients were stratified by annular area measured by multi\u2010slice computed tomography, defining a small annulus as \u2264\u2009430\u2009mm\n                      <jats:sup>2<\/jats:sup>\n                      . Primary endpoints at 12 months were: (i) a clinical composite of all\u2010cause death, disabling stroke, or heart failure rehospitalization, and (ii) a composite endpoint of bioprosthetic valve dysfunction. Secondary endpoints included VARC\u20103\u2013defined procedural and early outcomes and valve hemodynamic performance.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The study population comprised 218 patients, of whom 91 (41.7%) had a small annulus. VARC\u20103 technical success was high and comparable between small and non\u2010small annuli (96.7% vs. 96.1%). Patients with small annuli had higher early post\u2010procedural mean transvalvular gradients (7.7\u2009\u00b1\u20093.8 vs. 6.6\u2009\u00b1\u20093.0\u2009mmHg;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.029) and smaller effective orifice areas index (1.1\u2009\u00b1\u20090.3 vs. 1.3\u2009\u00b1\u20090.2\u2009cm\n                      <jats:sup>2<\/jats:sup>\n                      \/m\n                      <jats:sup>2<\/jats:sup>\n                      ;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.037), while the incidence of mean gradients \u2265\u200920\u2009mmHg remained low (1.1% vs. 0.0%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.432). At 12 months, the clinical composite endpoint occurred in 8.8% of patients with small annuli and 10.2% with non\u2010small annuli (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.759). Bioprosthetic valve dysfunction was infrequent and similar between groups (6.6% vs. 6.3%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.875).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>TAVI with the Navitor intra\u2010annular self\u2010expanding valve was associated with high procedural success, favorable valve hemodynamics, and comparable mid\u2010term clinical outcomes irrespective of annular size.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ccd.70879","type":"journal-article","created":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T12:32:57Z","timestamp":1789648377000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of Aortic Annulus Size on Clinical and Hemodynamic Outcomes of Transcatheter Aortic Valve Implantation With the Navitor Valve"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1998-6370","authenticated-orcid":false,"given":"Matteo","family":"Casenghi","sequence":"first","affiliation":[{"name":"Department of Cardiology Sant'Andrea Hospital Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6588-4906","authenticated-orcid":false,"given":"Sara","family":"Corradetti","sequence":"additional","affiliation":[{"name":"Department of Clinical and Molecular Medicine Sapienza University Rome Italy"},{"name":"Cardiovascular Center Aalst, AZORG Aalst Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7017-778X","authenticated-orcid":false,"given":"Pasquale","family":"Paolisso","sequence":"additional","affiliation":[{"name":"Department of Cardiology Sant'Andrea Hospital Rome Italy"},{"name":"Department of Clinical and Molecular Medicine Sapienza University 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