{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T10:49:31Z","timestamp":1790074171921,"version":"4.0.1"},"reference-count":21,"publisher":"Springer Science and Business Media LLC","issue":"12","license":[{"start":{"date-parts":[[2021,8,13]],"date-time":"2021-08-13T00:00:00Z","timestamp":1628812800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,8,13]],"date-time":"2021-08-13T00:00:00Z","timestamp":1628812800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universit\u00e4tsklinikum Hamburg-Eppendorf (UKE)"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Clin Res Cardiol"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>A small aortic annulus is associated with increased risk of prosthesis\u2013patient mismatch (PPM) after transcatheter aortic valve implantation (TAVI). Whether specific transcatheter heart valve (THV) designs yield superior hemodynamic performance in these small anatomies remains unclear.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Data from 8411 consecutive patients treated with TAVI from May 2012 to April 2019 at four German centers were retrospectively evaluated. A small aortic annulus was defined as multidetector computed tomography-derived annulus area\u2009&lt;\u2009400 mm<jats:sup>2<\/jats:sup>. TAVI was performed with a balloon-expanding intra-annular (Sapien-3, <jats:italic>n<\/jats:italic>\u2009=\u2009288), self-expanding intra-annular (Portico, <jats:italic>n<\/jats:italic>\u2009=\u2009110), self-expanding supra-annular (Evolut, <jats:italic>n<\/jats:italic>\u2009=\u2009179 and Acurate-Neo, <jats:italic>n<\/jats:italic>\u2009=\u2009428) and mechanically expanding infra-annular (Lotus, <jats:italic>n<\/jats:italic>\u2009=\u200964) THV according to local practice. PPM was defined as indexed effective orifice area\u2009\u2264\u20090.85cm<jats:sup>2<\/jats:sup>\/m<jats:sup>2<\/jats:sup>.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>A small annulus was found in 1069 (12.7%) patients. PPM was detected in 38.3% overall with a higher prevalence after implantation of a balloon-expanding intra-annular or mechanically expanding infra-annular THV compared to self-expanding intra- and supra-annular THV. Multivariable analysis linked self-expanding THV (Evolut: Odds ratio [OR] 0.341, Acurate-Neo: OR 0.436, Portico: OR 0.291), postdilatation (OR 0.648) and age (OR 0.968) to lower rates of PPM, while aortic valve calcification was associated with an increased risk (OR 1.001). Paravalvular regurgitation\u2009&gt;\u2009mild was more frequent after TAVI with self-expanding THV (<jats:italic>p<\/jats:italic>\u2009=\u20090.04).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>In this large contemporary multicenter patient population, a substantial number of patients with a small aortic anatomy were left with PPM after TAVI. Self-expanding supra- and intra-annular THV demonstrated superior hemodynamics in these patients at risk, however at the cost of higher rates of residual paravalvular regurgitation.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Graphic abstract<\/jats:title>\n                \n              <\/jats:sec>","DOI":"10.1007\/s00392-021-01918-8","type":"journal-article","created":{"date-parts":[[2021,8,13]],"date-time":"2021-08-13T04:03:03Z","timestamp":1628827383000},"page":"1957-1966","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":37,"title":["Transcatheter aortic valve implantation in patients with a small aortic annulus: performance of supra-, intra- and infra-annular transcatheter heart valves"],"prefix":"10.1007","volume":"110","author":[{"given":"Lisa","family":"Voigtl\u00e4nder","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Won-Keun","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor","family":"Mauri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alina","family":"Go\u00dfling","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Renker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atsushi","family":"Sugiura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Linder","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tobias","family":"Schmidt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niklas","family":"Schofer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dirk","family":"Westermann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hermann","family":"Reichenspurner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georg","family":"Nickenig","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Blankenberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Hamm","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lenard","family":"Conradi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matti","family":"Adam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan-Malte","family":"Sinning","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3940-9079","authenticated-orcid":false,"given":"Moritz","family":"Seiffert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,8,13]]},"reference":[{"key":"1918_CR1","doi-asserted-by":"publisher","first-page":"924","DOI":"10.1016\/j.jcmg.2015.10.026","volume":"9","author":"V Dayan","year":"2016","unstructured":"Dayan V, Vignolo G, Soca G et al (2016) Predictors and outcomes of prosthesis-patient mismatch after aortic valve replacement. 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MR received lecture fees from Abbott. TS received speaker honoraria and travel support from Edwards Lifesciences, Boston Scientific and Medtronic. NS received travel support from Edwards Lifesciences and St. Jude Medical, speaker honoria and travel support from Boston Scientific. DW received speaker honoria from Astra Zeneca, Bayer, Biotronik, Berlin-Chemie, Boehringer-Ingelheim, Novartis and Pfizer. CH is a member of the Medtronic advisory board. LC is a consultant and proctor for Edwards Lifesciences, Boston Scientific and Abbott and member of the speaker\u00b4s bureau for Edwards Lifesciences, Boston Scientific, Abbott and Medtronic. MA received personal fees from Edwards Lifescience and Boston Scientific, grants and personal fees from Medtronic. JMS is consultant for Abbott, Abiomed, Boston Scientific and Medtronic and receives speaker honoraria from Abbott, Abiomed, Boston Scientific, Edwards Lifesciences and Medtronic. MS served as consultant for JenaValve, received TC from Edwards Lifesciences, Symetis, Boston Scientific and Biotronik and received speaking honoraria from Medtronic. All other authors report no conflicts of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}