{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T14:13:33Z","timestamp":1793196813794,"version":"4.5.0"},"reference-count":26,"publisher":"Springer Science and Business Media LLC","issue":"11","license":[{"start":{"date-parts":[[2025,4,29]],"date-time":"2025-04-29T00:00:00Z","timestamp":1745884800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,4,29]],"date-time":"2025-04-29T00:00:00Z","timestamp":1745884800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100006254","name":"Ruhr-Universit\u00e4t Bochum","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100006254","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Clin Res Cardiol"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to compare in-hospital and long-term outcomes of patients with bail-out valve-in-valve TAVI due to a primarily failed transcatheter aortic valves procedure (bViV-TAVI) versus a successful transcatheter aortic valve implantation (TAVI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We recorded bViV-TAVI procedures at our center from February 2011 to March 2022. Primary endpoint was long-term mortality. In-hospital mortality, stroke, acute kidney failure, need for new permanent pacemaker, and duration of intervention were secondary endpoints.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      4555 patients undergoing TAVI were retrospectively included. 231 matched (77:154) patients were analyzed. BViV-TAVI was a rare event (1.9%). In 76.7% of the cases transcatheter valve embolization and migration were the reasons for implanting a second valve in the same procedure. Significant PVL accounted for bViV-TAVI in 23.4% of the patients. The duration of the intervention was significantly longer for the bViV-TAVI group (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt; 0.001). BViV-TAVI patients showed higher rates of a new permanent pacemaker implantation (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009= 0.013) and the postprocedural mean pressure was significantly higher (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009= 0.03). Concerning the other secondary endpoints there was a trend for a higher event rate in bVIV-TAVI patients which did not reach significant difference. After an average follow-up period of 4.9 \u00b1\u20093.0 years, mortality was significantly higher in the bViV-TAVI group (54.5% vs. 39.0%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009= 0.025).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The implantation of a second valve during the same procedure as bail-out is a feasible alternative treatment option in patients with failed transcatheter aortic valve procedures. However, increased long-term mortality must be taken into account.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Graphical abstract<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1007\/s00392-025-02640-5","type":"journal-article","created":{"date-parts":[[2025,4,29]],"date-time":"2025-04-29T11:35:47Z","timestamp":1745926547000},"page":"1445-1454","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Long-term outcome of bail-out ViV-TAVI at index procedure"],"prefix":"10.1007","volume":"114","author":[{"given":"Isabel","family":"Horn","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hazem","family":"Omran","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabine","family":"Bleiziffer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Smita","family":"Scholtz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kai","family":"Friedrichs","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cornelia","family":"Piper","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johanna","family":"Bormann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Waezsada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Max","family":"Potratz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ren\u00e9","family":"Schramm","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Volker","family":"Rudolph","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanja K.","family":"Rudolph","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,4,29]]},"reference":[{"key":"2640_CR1","doi-asserted-by":"publisher","first-page":"561","DOI":"10.1093\/eurheartj\/ehab395","volume":"43","author":"A Vahanian","year":"2022","unstructured":"Vahanian A, Beyersdorf F, Praz F, Milojevic M, Baldus S, Bauersachs J et al (2022) 2021 ESC\/EACTS guidelines for the management of valvular heart disease. Eur Heart J 43:561\u2013632. https:\/\/doi.org\/10.1093\/eurheartj\/ehab395","journal-title":"Eur Heart J"},{"key":"2640_CR2","doi-asserted-by":"publisher","first-page":"182","DOI":"10.1007\/s12181-020-00398-w","volume":"14","author":"K-H Kuck","year":"2020","unstructured":"Kuck K-H, Bleiziffer S, Eggebrecht H, Ensminger S, Frerker C, M\u00f6llmann H et al (2020) Konsensuspapier der Deutschen Gesellschaft f\u00fcr Kardiologie (DGK) und der Deutschen Gesellschaft f\u00fcr Thorax-, Herz- und Gef\u00e4\u00dfchirurgie (DGTHG) zur kathetergest\u00fctzten Aortenklappenimplantation (TAVI) 2020. Kardiologe 14:182\u2013204. https:\/\/doi.org\/10.1007\/s12181-020-00398-w","journal-title":"Kardiologe"},{"key":"2640_CR3","doi-asserted-by":"publisher","first-page":"1609","DOI":"10.1056\/NEJMoa1514616","volume":"374","author":"MB Leon","year":"2016","unstructured":"Leon MB, Smith CR, Mack MJ, Makkar RR, Svensson LG, Kodali SK et al (2016) Transcatheter or surgical aortic-valve replacement in intermediate-risk patients. N Engl J Med 374:1609\u20131620. https:\/\/doi.org\/10.1056\/NEJMoa1514616","journal-title":"N Engl J Med"},{"key":"2640_CR4","doi-asserted-by":"publisher","first-page":"799","DOI":"10.1056\/NEJMoa1910555","volume":"382","author":"RR Makkar","year":"2020","unstructured":"Makkar RR, Thourani VH, Mack MJ, Kodali SK, Kapadia S, Webb JG et al (2020) Five-year outcomes of transcatheter or surgical aortic-valve replacement. N Engl J Med 382:799\u2013809. https:\/\/doi.org\/10.1056\/NEJMoa1910555","journal-title":"N Engl J Med"},{"key":"2640_CR5","doi-asserted-by":"publisher","first-page":"1695","DOI":"10.1056\/NEJMoa1814052","volume":"380","author":"MJ Mack","year":"2019","unstructured":"Mack MJ, Leon MB, Thourani VH, Makkar R, Kodali SK, Russo M et al (2019) Transcatheter aortic-valve replacement with a balloon-expandable valve in low-risk patients. N Engl J Med 380:1695\u20131705. https:\/\/doi.org\/10.1056\/NEJMoa1814052","journal-title":"N Engl J Med"},{"key":"2640_CR6","doi-asserted-by":"publisher","first-page":"1706","DOI":"10.1056\/NEJMoa1816885","volume":"380","author":"JJ Popma","year":"2019","unstructured":"Popma JJ, Deeb GM, Yakubov SJ, Mumtaz M, Gada H, O\u2019Hair D et al (2019) Transcatheter aortic-valve replacement with a self-expanding valve in low-risk patients. N Engl J Med 380:1706\u20131715. https:\/\/doi.org\/10.1056\/NEJMoa1816885","journal-title":"N Engl J Med"},{"key":"2640_CR7","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2307447","author":"MJ Mack","year":"2023","unstructured":"Mack MJ, Leon MB, Thourani VH, Pibarot P, Hahn RT, Genereux P et al (2023) Transcatheter aortic-valve replacement in low-risk patients at five years. N Engl J Med. https:\/\/doi.org\/10.1056\/NEJMoa2307447","journal-title":"N Engl J Med"},{"key":"2640_CR8","doi-asserted-by":"publisher","first-page":"1663","DOI":"10.1016\/j.jacc.2023.02.017","volume":"81","author":"JK Forrest","year":"2023","unstructured":"Forrest JK, Deeb GM, Yakubov SJ, Gada H, Mumtaz MA, Ramlawi B et al (2023) 3-Year outcomes after transcatheter or surgical aortic valve replacement in low-risk patients with aortic stenosis. J Am Coll Cardiol 81:1663\u20131674. https:\/\/doi.org\/10.1016\/j.jacc.2023.02.017","journal-title":"J Am Coll Cardiol"},{"key":"2640_CR9","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehae043","author":"HGH Thyregod","year":"2024","unstructured":"Thyregod HGH, J\u00f8rgensen TH, Ihlemann N, Steinbr\u00fcchel DA, Nissen H, Kjeldsen BJ et al (2024) Transcatheter or surgical aortic valve implantation: 10-year outcomes of the NOTION trial. Eur Heart J. https:\/\/doi.org\/10.1093\/eurheartj\/ehae043","journal-title":"Eur Heart J"},{"key":"2640_CR10","doi-asserted-by":"publisher","first-page":"2163","DOI":"10.1016\/j.jacc.2023.09.813","volume":"82","author":"JK Forrest","year":"2023","unstructured":"Forrest JK, Deeb GM, Yakubov SJ, Gada H, Mumtaz MA, Ramlawi B et al (2023) 4-year outcomes of patients with aortic stenosis in the Evolut low risk trial. J Am Coll Cardiol 82:2163\u20132165. https:\/\/doi.org\/10.1016\/j.jacc.2023.09.813","journal-title":"J Am Coll Cardiol"},{"key":"2640_CR11","doi-asserted-by":"publisher","first-page":"508","DOI":"10.1016\/j.rec.2016.08.003","volume":"70","author":"M Nobre Menezes","year":"2017","unstructured":"Nobre Menezes M, Da Canas Silva P, Nobre \u00c2, Infantede Oliveira E, Carrilho Ferreira P, Pinto FJ (2017) Subacute retrograde TAVI migration successfully treated with a valve-in-valve procedure. Rev Esp Cardiol (Engl Ed) 70:508\u2013510. https:\/\/doi.org\/10.1016\/j.rec.2016.08.003","journal-title":"Rev Esp Cardiol (Engl Ed)"},{"key":"2640_CR12","doi-asserted-by":"publisher","first-page":"598","DOI":"10.1016\/j.ihj.2015.08.018","volume":"67","author":"R Showkathali","year":"2015","unstructured":"Showkathali R, Dworakowski R, MacCarthy P (2015) Valve in valve implantation to prevent acute prosthetic valve migration in transcatheter aortic valve implantation (TAVI). Indian Heart J 67:598\u2013599. https:\/\/doi.org\/10.1016\/j.ihj.2015.08.018","journal-title":"Indian Heart J"},{"key":"2640_CR13","doi-asserted-by":"publisher","first-page":"3156","DOI":"10.1093\/eurheartj\/ehz429","volume":"40","author":"W-K Kim","year":"2019","unstructured":"Kim W-K, Sch\u00e4fer U, Tchetche D, Nef H, Arnold M, Avanzas P et al (2019) Incidence and outcome of peri-procedural transcatheter heart valve embolization and migration: the TRAVEL registry (TranscatheteR HeArt Valve EmboLization and Migration). Eur Heart J 40:3156\u20133165. https:\/\/doi.org\/10.1093\/eurheartj\/ehz429","journal-title":"Eur Heart J"},{"key":"2640_CR14","doi-asserted-by":"publisher","DOI":"10.1007\/s00392-023-02239-8","author":"A Giordano","year":"2023","unstructured":"Giordano A, Corcione N, Barbanti M, Costa G, Dipietro E, Amat-Santos IJ et al (2023) Features and outcomes of bailout repeat transcatheter aortic valve implantation (TAVI): the Bailout Acute TAVI-in-TAVI to Lessen Events (BATTLE) international registry. Clin Res Cardiol. https:\/\/doi.org\/10.1007\/s00392-023-02239-8","journal-title":"Clin Res Cardiol"},{"key":"2640_CR15","doi-asserted-by":"publisher","first-page":"1277","DOI":"10.1016\/j.jaccas.2022.07.038","volume":"4","author":"T Attisano","year":"2022","unstructured":"Attisano T, Bellino M, Vigorito F, Maione A, Ravera A, Pierri A et al (2022) Bioprosthetic valve fracture after TAVR complicated by balloon rupture: bail-out TAVR in TAVR in SAVR. JACC Case Rep 4:1277\u20131282. https:\/\/doi.org\/10.1016\/j.jaccas.2022.07.038","journal-title":"JACC Case Rep"},{"key":"2640_CR16","doi-asserted-by":"publisher","first-page":"936","DOI":"10.1001\/jamacardio.2021.1145","volume":"6","author":"U Landes","year":"2021","unstructured":"Landes U, Witberg G, Sathananthan J, Kim W-K, Codner P, Buzzatti N et al (2021) Incidence, causes, and outcomes associated with urgent implantation of a supplementary valve during transcatheter aortic valve replacement. JAMA Cardiol 6:936\u2013944. https:\/\/doi.org\/10.1001\/jamacardio.2021.1145","journal-title":"JAMA Cardiol"},{"key":"2640_CR17","doi-asserted-by":"publisher","first-page":"1825","DOI":"10.1093\/eurheartj\/ehaa799","volume":"42","author":"P G\u00e9n\u00e9reux","year":"2021","unstructured":"G\u00e9n\u00e9reux P, Piazza N, Alu MC, Nazif T, Hahn RT, Pibarot P et al (2021) Valve Academic Research Consortium 3: updated endpoint definitions for aortic valve clinical research. Eur Heart J 42:1825\u20131857. https:\/\/doi.org\/10.1093\/eurheartj\/ehaa799","journal-title":"Eur Heart J"},{"key":"2640_CR18","doi-asserted-by":"publisher","DOI":"10.3389\/fcvm.2022.928740","volume":"9","author":"D Frumkin","year":"2022","unstructured":"Frumkin D, Pietron M, Kind A, Brand A, Knebel F, Laule M, Leistner DM, Landmesser U, Krackhardt F, Sherif M, S\u00fcndermann SH, Grubitzsch H, Lembcke A, Niehues SM, Stangl K, Dreger H (2022) Valve embolization during transcatheter aortic valve implantation: Incidence, risk factors and follow-up by computed tomography. Front Cardiovasc Med 9:928740. https:\/\/doi.org\/10.3389\/fcvm.2022.928740","journal-title":"Front Cardiovasc Med"},{"key":"2640_CR19","doi-asserted-by":"publisher","first-page":"418","DOI":"10.1016\/j.jacc.2013.04.037","volume":"62","author":"RR Makkar","year":"2013","unstructured":"Makkar RR, Jilaihawi H, Chakravarty T, Fontana GP, Kapadia S, Babaliaros V et al (2013) Determinants and outcomes of acute transcatheter valve-in-valve therapy or embolization: a study of multiple valve implants in the U.S. PARTNER trial (Placement of AoRTic TraNscathetER Valve Trial Edwards SAPIEN Transcatheter Heart Valve). J Am College Cardiol 62:418\u2013430. https:\/\/doi.org\/10.1016\/j.jacc.2013.04.037","journal-title":"J Am College Cardiol"},{"issue":"5","key":"2640_CR20","doi-asserted-by":"publisher","first-page":"571","DOI":"10.1016\/j.jcin.2012.03.008","volume":"5","author":"S Toggweiler","year":"2012","unstructured":"Toggweiler S, Wood DA, Rod\u00e9s-Cabau J, Kapadia S, Willson AB, Ye J, Cheung A, Leipsic J, Binder RK, Gurvitch R, Freeman M, Thompson CR, Svensson LG, Dumont E, Tuzcu EM, Webb JG (2012) Transcatheter valve-in-valve implantation for failed balloon-expandable transcatheter aortic valves. JACC Cardiovasc Interv 5(5):571\u2013577. https:\/\/doi.org\/10.1016\/j.jcin.2012.03.008","journal-title":"JACC Cardiovasc Interv"},{"issue":"2","key":"2640_CR21","doi-asserted-by":"publisher","first-page":"267","DOI":"10.1093\/ejcts\/ezy034","volume":"54","author":"M Arsalan","year":"2018","unstructured":"Arsalan M, Kim WK, Van Linden A, Liebetrau C, Pollock BD, Filardo G, Renker M, M\u00f6llmann H, Doss M, Fischer-Rasokat U, Skwara A, Hamm CW, Walther T (2018) Predictors and outcome of conversion to cardiac surgery during transcatheter aortic valve implantation. Eur J Cardio-thorac Surg Off J Eur Assoc Cardio-thorac Surg 54(2):267\u2013272. https:\/\/doi.org\/10.1093\/ejcts\/ezy034","journal-title":"Eur J Cardio-thorac Surg Off J Eur Assoc Cardio-thorac Surg"},{"issue":"12","key":"2640_CR22","doi-asserted-by":"publisher","first-page":"1767","DOI":"10.1016\/j.amjcard.2015.03.024","volume":"115","author":"UN Ibebuogu","year":"2015","unstructured":"Ibebuogu UN, Giri S, Bolorunduro O, Tartara P, Kar S, Holmes D, Alli O (2015) Review of reported causes of device embolization following trans-catheter aortic valve implantation. Am J Cardiol 115(12):1767\u20131772. https:\/\/doi.org\/10.1016\/j.amjcard.2015.03.024","journal-title":"Am J Cardiol"},{"issue":"11","key":"2640_CR23","doi-asserted-by":"publisher","first-page":"1285","DOI":"10.4244\/EIJV7I11A203","volume":"7","author":"GP Ussia","year":"2012","unstructured":"Ussia GP, Barbanti M, Sarkar K, Aruta P, Scarabelli M, Cammalleri V, Imm\u00e8 S, Pistritto AM, Gulino S, Mul\u00e8 M, Deste W, Cannata S, Tamburino C (2012) Transcatheter aortic bioprosthesis dislocation: technical aspects and midterm follow-up. EuroIntervention J EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology 7(11):1285\u20131292. https:\/\/doi.org\/10.4244\/EIJV7I11A203","journal-title":"EuroIntervention J EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology"},{"issue":"36","key":"2640_CR24","doi-asserted-by":"publisher","first-page":"2729","DOI":"10.1093\/eurheartj\/ehx295","volume":"38","author":"U Gerckens","year":"2017","unstructured":"Gerckens U, Tamburino C, Bleiziffer S, Bosmans J, Wenaweser P, Brecker S, Guo J, Linke A (2017) Final 5-year clinical and echocardiographic results for treatment of severe aortic stenosis with a self-expanding bioprosthesis from the ADVANCE Study. Eur Heart J 38(36):2729\u20132738. https:\/\/doi.org\/10.1093\/eurheartj\/ehx295","journal-title":"Eur Heart J"},{"issue":"30","key":"2640_CR25","doi-asserted-by":"publisher","first-page":"2912","DOI":"10.1093\/eurheartj\/ehab375","volume":"42","author":"TH J\u00f8rgensen","year":"2021","unstructured":"J\u00f8rgensen TH, Thyregod HGH, Ihlemann N, Nissen H, Petursson P, Kjeldsen BJ, Steinbr\u00fcchel DA, Olsen PS, S\u00f8ndergaard L (2021) Eight-year outcomes for patients with aortic valve stenosis at low surgical risk randomized to transcatheter vs. surgical aortic valve replacement. Eur Heart J 42(30):2912\u20132919. https:\/\/doi.org\/10.1093\/eurheartj\/ehab375","journal-title":"Eur Heart J"},{"issue":"10","key":"2640_CR26","doi-asserted-by":"publisher","first-page":"1000","DOI":"10.1001\/jamacardio.2022.2695","volume":"7","author":"NM Van Mieghem","year":"2022","unstructured":"Van Mieghem NM, Deeb GM, S\u00f8ndergaard L, Grube E, Windecker S, Gada H, Mumtaz M, Olsen PS, Heiser JC, Merhi W, Kleiman NS, Chetcuti SJ, Gleason TG, Lee JS, Cheng W, Makkar RR, Crestanello J, George B, George I, Kodali S et al (2022) Self-expanding transcatheter vs surgical aortic valve replacement in intermediate-risk patients: 5-year outcomes of the SURTAVI randomized clinical trial. JAMA Cardiol 7(10):1000\u20131008. https:\/\/doi.org\/10.1001\/jamacardio.2022.2695","journal-title":"JAMA Cardiol"}],"container-title":["Clinical Research in Cardiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00392-025-02640-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00392-025-02640-5\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00392-025-02640-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T00:02:44Z","timestamp":1761091364000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00392-025-02640-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,29]]},"references-count":26,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2025,11]]}},"alternative-id":["2640"],"URL":"https:\/\/doi.org\/10.1007\/s00392-025-02640-5","relation":{},"ISSN":["1861-0684","1861-0692"],"issn-type":[{"value":"1861-0684","type":"print"},{"value":"1861-0692","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,29]]},"assertion":[{"value":"3 June 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 March 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 April 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"S. Bleiziffer declares speaker fess from Edwards Lifesciences and Boston Scientific and speaker fees and advisory board activites for Medtronic and Abbott. T.K. Rudolph is proctor for JenaValve. All other authors declare to have no conflicts of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}