{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T08:11:45Z","timestamp":1791447105564,"version":"4.3.3"},"reference-count":25,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11","license":[{"start":{"date-parts":[[2023,11,1]],"date-time":"2023-11-01T00:00:00Z","timestamp":1698796800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Interventions"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:sec>\n            <jats:title>BACKGROUND:<\/jats:title>\n            <jats:p>Coronary accessibility following redo\u2013transcatheter aortic valve replacement (redo-TAVR) is increasingly important, particularly in younger low-risk patients. This study aimed to predict coronary accessibility after simulated Sapien-3 balloon-expandable valve implantation within an Evolut supra-annular, self-expanding valve using pre-TAVR computed tomography (CT) imaging.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>METHODS:<\/jats:title>\n            <jats:p>A total of 219 pre-TAVR CT scans from the Evolut Low-Risk CT substudy were analyzed. Virtual Evolut and Sapien-3 valves were sized using CT-based diameters. Two initial Evolut implant depths were analyzed, 3 and 5 mm. Coronary accessibility was evaluated for 2 Sapien-3 in Evolut implant positions: Sapien-3 outflow at Evolut node 4 and Evolut node 5.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS:<\/jats:title>\n            <jats:p>\n              With a 3-mm initial Evolut implant depth, suitable coronary access was predicted in 84% of patients with the Sapien-3 outflow at Evolut node 4, and in 31% of cases with the Sapien-3 outflow at Evolut node 5 (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). Coronary accessibility improved with a 5-mm Evolut implant depth: 97% at node 4 and 65% at node 5 (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). When comparing 3- to 5-mm Evolut implant depth, sinus sequestration was the lowest with Sapien-3 outflow at Evolut node 4 (13% versus 2%;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001), and the highest at Evolut node 5 (61% versus 32%;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSIONS:<\/jats:title>\n            <jats:p>Coronary accessibility after Sapien-3 in Evolut redo-TAVR relates to the initial Evolut implant depth, the Sapien-3 outflow position within the Evolut, and the native annular anatomy. This CT-based quantitative analysis may provide useful information to inform and refine individualized preprocedural CT planning of the initial TAVR and guide lifetime management for future coronary access after redo-TAVR.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>REGISTRATION:<\/jats:title>\n            <jats:p>\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n              ; Unique identifier: NCT02701283.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circinterventions.123.013238","type":"journal-article","created":{"date-parts":[[2023,11,21]],"date-time":"2023-11-21T19:00:39Z","timestamp":1700593239000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":33,"title":["Feasibility of Coronary Access Following Redo-TAVR for Evolut Failure: A Computed Tomography Simulation Study"],"prefix":"10.1161","volume":"16","clinical-trial-number":[{"clinical-trial-number":"nct02701283","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7219-990X","authenticated-orcid":true,"given":"Gilbert H.L.","family":"Tang","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Surgery, Mount Sinai Health System, New York (G.H.L.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julianne","family":"Spencer","sequence":"additional","affiliation":[{"name":"Structural Heart &amp; Aortic, Medtronic, Mounds View, MN (J. Spencer, J.Z.S., G.S., J.J.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6043-3137","authenticated-orcid":true,"given":"Toby","family":"Rogers","sequence":"additional","affiliation":[{"name":"Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington DC (T.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1369-5521","authenticated-orcid":true,"given":"Kendra J.","family":"Grubb","sequence":"additional","affiliation":[{"name":"Division of Cardiothoracic Surgery (K.J.G.), Emory University, Atlanta, GA."},{"name":"Structural Heart and Valve Center (K.J.G., P.G.), Emory University, Atlanta, GA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5739-9030","authenticated-orcid":true,"given":"Patrick","family":"Gleason","sequence":"additional","affiliation":[{"name":"Structural Heart and Valve Center (K.J.G., P.G.), Emory University, Atlanta, GA."},{"name":"Division of Cardiology (P.G.), Emory University, Atlanta, GA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hemal","family":"Gada","sequence":"additional","affiliation":[{"name":"University of Pittsburgh Medical Center Pinnacle Health, PA (H.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Mahoney","sequence":"additional","affiliation":[{"name":"Sentara Heart Hospital, Norfolk, VA (P.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harold L.","family":"Dauerman","sequence":"additional","affiliation":[{"name":"University of Vermont Larner College of Medicine, Burlington (H.L.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4079-3482","authenticated-orcid":true,"given":"John K.","family":"Forrest","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Yale School of Medicine, New Haven, CT (J.K.F.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2880-6132","authenticated-orcid":true,"given":"Michael J.","family":"Reardon","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Houston Methodist, TX (M.J.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philipp","family":"Blanke","sequence":"additional","affiliation":[{"name":"Center for Heart Valve Innovation, St. Paul\u2019s Hospital, University of British Columbia, Vancouver, Canada (P.B., J.A.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathon A.","family":"Leipsic","sequence":"additional","affiliation":[{"name":"Center for Heart Valve Innovation, St. Paul\u2019s Hospital, University of British Columbia, Vancouver, Canada (P.B., J.A.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9596-558X","authenticated-orcid":true,"given":"Mohamed","family":"Abdel-Wahab","sequence":"additional","affiliation":[{"name":"Heart Center Leipzig at University of Leipzig, Germany (M.A.-W.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9233-1242","authenticated-orcid":true,"given":"Guilherme F.","family":"Attizzani","sequence":"additional","affiliation":[{"name":"Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, OH (G.F.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8849-7426","authenticated-orcid":true,"given":"Rishi","family":"Puri","sequence":"additional","affiliation":[{"name":"Cleveland Clinic, OH (R.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Caskey","sequence":"additional","affiliation":[{"name":"Abrazo Arizona Heart Hospital, Phoenix (M.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine J.","family":"Chung","sequence":"additional","affiliation":[{"name":"Division of Cardiology, University of Washington Medical Center, Seattle (C.J.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9321-8241","authenticated-orcid":true,"given":"Ying-Hwa","family":"Chen","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, Taipei Veterans General Hospital, Taiwan (Y.-H.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dariusz","family":"Dudek","sequence":"additional","affiliation":[{"name":"Jagiellonian University Medical College, Krakow, Poland (D.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7272-9632","authenticated-orcid":true,"given":"Keith B.","family":"Allen","sequence":"additional","affiliation":[{"name":"St. Luke\u2019s Mid America Heart Institute, Kansas City, MO (K.B.A., A.K.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5309-3058","authenticated-orcid":true,"given":"Adnan K.","family":"Chhatriwalla","sequence":"additional","affiliation":[{"name":"St. Luke\u2019s Mid America Heart Institute, Kansas City, MO (K.B.A., A.K.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0659-9291","authenticated-orcid":true,"given":"Wah Wah","family":"Htun","sequence":"additional","affiliation":[{"name":"Gundersen Health System, La Crosse, WI (W.W.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9039-6130","authenticated-orcid":true,"given":"Daniel J.","family":"Blackman","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Leeds Teaching Hospitals, Leeds, United Kingdom (D.J.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5055-2917","authenticated-orcid":true,"given":"Giuseppe","family":"Tarantini","sequence":"additional","affiliation":[{"name":"Thoracic, Vascular Sciences and Public Health, University of Padua Medical School, Italy (G.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge","family":"Zhingre Sanchez","sequence":"additional","affiliation":[{"name":"Structural Heart &amp; Aortic, Medtronic, Mounds View, MN (J. 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