{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T09:35:35Z","timestamp":1773394535791,"version":"3.50.1"},"reference-count":28,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2021,3,18]],"date-time":"2021-03-18T00:00:00Z","timestamp":1616025600000},"content-version":"unspecified","delay-in-days":17,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Open Heart"],"accepted":{"date-parts":[[2021,3,5]]},"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>The balloon-expandable SAPIEN 3 (S3) is superior to the older-generation balloon-expandable SAPIEN XT (XT) in a lower incidence of paravalvular aortic regurgitation, lower complication rates and better survival in transcatheter aortic valve implantation (TAVI). However, prosthesis\u2013patient mismatch (PPM) more frequently occurs in S3 than XT. Further, little information is available on PPM after TAVI using S3 in Asians. This study aims to determine the incidence and predictors of PPM in S3 by focusing on the difference between S3 and XT using data from a Japanese multicentre registry.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>From the Optimised transCathEter vAlvular iNtervention-TAVI (OCEAN-TAVI) registry, 2134 patients undergoing TAVI using S3 or XT were included. PPM was defined as moderate if \u22670.65 but \u22660.85 cm<jats:sup>2<\/jats:sup>\/m<jats:sup>2<\/jats:sup> or severe if &lt;0.65 cm<jats:sup>2<\/jats:sup>\/m<jats:sup>2<\/jats:sup> at the indexed effective orifice area by postprocedural echocardiography.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The incidence of moderate and severe PPM in S3 was 13.3% and 1.3%, respectively. The 20 mm transcatheter heart valve (THV) was more frequently used in S3 than XT (7.4% vs 2.4%, p&lt;0.0001). PPM was more frequently observed in S3 than XT (14.7% vs 8.8%, p&lt;0.0001). Multivariate logistic regression analysis revealed S3 predicted PPM (OR 1.92 (95% CI 1.35 to 2.74), p=0.0003). The mutual predictors for PPM between S3 and XT were younger age, larger body surface area, smaller aortic valve area, no balloon postdilatation and the use of 20 mm and 23 mm THV. When comparing 23 mm, 26 mm and 29 mm S3, the ORs of 20 mm S3 were 5.67 (95% CI 2.88 to 11.12), 19.24 (95% CI 8.13 to 46.86) and 51.03 (95% CI 12.28 to 280.77), respectively.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The incidence of PPM after TAVI using S3 was 14.6% overall in this Asian population. PPM was more frequently observed in S3 than XT. A considerable number of patients were treated by the 20 mm S3 in an Asian cohort. The 20 mm THV was identified as a strong predictor for PPM.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/openhrt-2020-001531","type":"journal-article","created":{"date-parts":[[2021,3,18]],"date-time":"2021-03-18T13:06:50Z","timestamp":1616072810000},"page":"e001531","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":13,"title":["Incidence and predictors of prosthesis\u2013patient mismatch after TAVI using SAPIEN 3 in Asian: differences between the newer and older balloon-expandable valve"],"prefix":"10.1136","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5490-7925","authenticated-orcid":false,"given":"Masaki","family":"Miyasaka","sequence":"first","affiliation":[{"name":"Cardiovascular Center, Sendai Kosei Hospital, Sendai, Miyagi, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Norio","family":"Tada","sequence":"additional","affiliation":[{"name":"Cardiovascular Center, Sendai Kosei Hospital, Sendai, Miyagi, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masataka","family":"Taguri","sequence":"additional","affiliation":[{"name":"Cardiovascular Center, Sendai Kosei Hospital, Sendai, Miyagi, Japan"},{"name":"Department of Biostatistics, Yokohama City University School of Medicine, Yokohama, Kanagawa, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shigeaki","family":"Kato","sequence":"additional","affiliation":[{"name":"Cardiovascular Center, Sendai Kosei Hospital, Sendai, Miyagi, Japan"},{"name":"Center for Regional Cooperation Iwaki, Meisei University, Iwaki, Fukushima, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1931-1012","authenticated-orcid":false,"given":"Yusuke","family":"Enta","sequence":"additional","affiliation":[{"name":"Cardiovascular Center, Sendai Kosei Hospital, Sendai, Miyagi, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masaki","family":"Hata","sequence":"additional","affiliation":[{"name":"Cardiovascular Center, Sendai Kosei Hospital, Sendai, Miyagi, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2297-5303","authenticated-orcid":false,"given":"Yusuke","family":"Watanabe","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Teikyo University Hospital, Itabashi-ku, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Toru","family":"Naganuma","sequence":"additional","affiliation":[{"name":"Interventional Cardiology Unit, New Tokyo Hospital, Matsudo, Chiba, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masahiro","family":"Yamawaki","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Saiseikai Yokohamashi Tobu Hospital, Yokohama, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Futoshi","family":"Yamanaka","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Shonankamakura General Hospital, Kamakura, Kanagawa, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shinichi","family":"Shirai","sequence":"additional","affiliation":[{"name":"Cardiology, Kokura Mem Hosp, Kitakyushu, Fukuoka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroshi","family":"Ueno","sequence":"additional","affiliation":[{"name":"Cardiovascular Medicine, University of Toyama University Hospital, Toyama, Toyama, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazuki","family":"Mizutani","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Minoru","family":"Tabata","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Tokyo Bay Urayasu Ichikawa Medical Center, Chiba, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kensuke","family":"Takagi","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Ogaki Municipal Hospital, Ogaki, Gifu, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5210-6382","authenticated-orcid":false,"given":"Masanori","family":"Yamamoto","sequence":"additional","affiliation":[{"name":"Interventional Cardiology, Toyohashi Heart Center, Toyohashi, Aichi, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kentaro","family":"Hayashida","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Keio University School of Medicine, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,3,18]]},"reference":[{"key":"2025081710181765000_8.1.e001531.1","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1016\/j.athoracsur.2018.01.090","article-title":"The incidence and consequence of prosthesis-patient mismatch after surgical aortic valve replacement","volume":"106","author":"Fallon","year":"2018","journal-title":"Ann Thorac Surg"},{"key":"2025081710181765000_8.1.e001531.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.09.001"},{"key":"2025081710181765000_8.1.e001531.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2016.11.033"},{"key":"2025081710181765000_8.1.e001531.4","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1161\/CIRCULATIONAHA.119.043971","article-title":"Impact of Sapien 3 Balloon-Expandable versus Evolut R Self-Expandable transcatheter aortic valve implantation in patients with aortic stenosis: data from a nationwide analysis","volume":"141","author":"Deharo","year":"2020","journal-title":"Circulation"},{"key":"2025081710181765000_8.1.e001531.5","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2019.07.027"},{"key":"2025081710181765000_8.1.e001531.6","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(19)32220-2"},{"key":"2025081710181765000_8.1.e001531.7","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1514616"},{"key":"2025081710181765000_8.1.e001531.8","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.116.022797"},{"key":"2025081710181765000_8.1.e001531.9","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehw112"},{"key":"2025081710181765000_8.1.e001531.10","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1093\/ehjci\/jex019","article-title":"Patient-prosthesis mismatch in new generation trans-catheter heart valves: a propensity score analysis","volume":"19","author":"Theron","year":"2018","journal-title":"Eur Heart J Cardiovasc Imaging"},{"key":"2025081710181765000_8.1.e001531.11","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2017.05.031"},{"key":"2025081710181765000_8.1.e001531.12","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2014.06.1195"},{"key":"2025081710181765000_8.1.e001531.13","doi-asserted-by":"crossref","first-page":"360","DOI":"10.1111\/jocs.14383","article-title":"Predictors and outcomes of patient-prosthesis mismatch after transcatheter aortic valve replacement","volume":"35","author":"Stamou","year":"2020","journal-title":"J Card Surg"},{"key":"2025081710181765000_8.1.e001531.14","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2018.01.273"},{"key":"2025081710181765000_8.1.e001531.15","doi-asserted-by":"crossref","DOI":"10.1161\/CIRCINTERVENTIONS.117.005088","article-title":"Gait speed can predict advanced clinical outcomes in patients who undergo transcatheter aortic valve replacement: insights from a Japanese multicenter registry","volume":"10","author":"Kano","year":"2017","journal-title":"Circ Cardiovasc Interv"},{"key":"2025081710181765000_8.1.e001531.16","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2012.09.001"},{"key":"2025081710181765000_8.1.e001531.17","doi-asserted-by":"crossref","DOI":"10.1161\/JAHA.119.014609","article-title":"Echocardiographic imaging challenges in obesity: guideline recommendations and limitations of adjusting to body size","volume":"9","author":"Singh","year":"2020","journal-title":"J Am Heart Assoc"},{"key":"2025081710181765000_8.1.e001531.18","doi-asserted-by":"publisher","DOI":"10.1093\/biomet\/70.1.41"},{"key":"2025081710181765000_8.1.e001531.19","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2019.03.007"},{"key":"2025081710181765000_8.1.e001531.20","first-page":"971","article-title":"Impact of prosthesis\u2010iteration evolution and sizing practice on the incidence of prosthesis\u2013patient mismatch after transcatheter aortic valve replacement","volume":"93","author":"Abdelghani","year":"2019","journal-title":"Catheter Cardiovasc Interv"},{"key":"2025081710181765000_8.1.e001531.21","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2018.05.035"},{"key":"2025081710181765000_8.1.e001531.22","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2014.10.014"},{"key":"2025081710181765000_8.1.e001531.23","doi-asserted-by":"publisher","DOI":"10.1093\/ehjci\/jew032"},{"key":"2025081710181765000_8.1.e001531.24","doi-asserted-by":"crossref","first-page":"672","DOI":"10.1253\/circj.CJ-18-1059","article-title":"Clinical outcomes of transcatheter aortic valve implantation in patients with extremely large annulus and SAPIEN 3 dimensions based on post-procedural computed tomography","volume":"83","author":"Miyasaka","year":"2019","journal-title":"Circ J"},{"key":"2025081710181765000_8.1.e001531.25","doi-asserted-by":"crossref","first-page":"1240","DOI":"10.4244\/EIJ-D-19-00541","article-title":"In-hospital and thirty-day outcomes of the SAPIEN 3 ultra balloon-expandable transcatheter aortic valve: the S3U registry","volume":"15","author":"Saia","year":"2020","journal-title":"EuroIntervention"},{"key":"2025081710181765000_8.1.e001531.26","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1016\/j.jjcc.2014.05.001","article-title":"First direct comparison of clinical outcomes between European and Asian cohorts in transcatheter aortic valve implantation: the Massy Study Group vs. the PREVAIL JAPAN trial","volume":"65","author":"Watanabe","year":"2015","journal-title":"J Cardiol"},{"key":"2025081710181765000_8.1.e001531.27","doi-asserted-by":"crossref","first-page":"1566","DOI":"10.1016\/j.amjcard.2015.08.021","article-title":"Comparison of aortic root anatomy and calcification distribution between Asian and Caucasian patients who underwent transcatheter aortic valve implantation","volume":"116","author":"Yoon","year":"2015","journal-title":"Am J Cardiol"},{"key":"2025081710181765000_8.1.e001531.28","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1814052"}],"container-title":["Open Heart"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/openhrt-2020-001531","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,17]],"date-time":"2025-08-17T17:18:26Z","timestamp":1755451106000},"score":1,"resource":{"primary":{"URL":"https:\/\/openheart.bmj.com\/lookup\/doi\/10.1136\/openhrt-2020-001531"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3]]},"references-count":28,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2021,3,18]]},"published-print":{"date-parts":[[2021,3]]}},"alternative-id":["10.1136\/openhrt-2020-001531"],"URL":"https:\/\/doi.org\/10.1136\/openhrt-2020-001531","relation":{},"ISSN":["2053-3624"],"issn-type":[{"value":"2053-3624","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,3]]}}}