{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T08:39:53Z","timestamp":1784709593869,"version":"3.55.0"},"reference-count":26,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Interventions"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Data comparing valve systems in the valve-in-valve transcatheter aortic valve replacement (TAVR) field have been obtained from retrospective studies. This prespecified secondary analysis of the LYTEN randomized trial (Comparison of the Balloon-Expandable Edwards Valve and Self-Expandable CoreValve Evolut R or Evolut PRO System for the Treatment of Small, Severely Dysfunctional Surgical Aortic Bioprostheses) aims to compare the 3-year hemodynamic performance and clinical outcomes between balloon-expandable valves (BEV) SAPIEN 3\/ULTRA (Edwards Lifesciences) and self-expanding valves (SEV) Evolut R\/PRO\/PRO+ (Medtronic) in valve-in-valve TAVR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>Patients with a failed small (\u226423 mm) surgical valve undergoing valve-in-valve TAVR were randomized to receive a SEV or a BEV. Patients had a clinical and valve hemodynamic (Doppler echocardiography) evaluation at 3-year follow-up. Study outcomes were defined according to VARC (Valve Academic Research Consortium)-2\/VARC-3 criteria. Intended performance of the valve was defined as mean gradient &lt;20 mm\u2009Hg, peak velocity &lt;3 m\/s, Doppler velocity index \u22650.25, and less than moderate aortic regurgitation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      Ninety-eight patients underwent TAVR (46 BEV [SAPIEN 3\/ULTRA], 52 SEV [Evolut R-PRO-PRO+]). At 3 years, patients receiving a SEV had a higher rate of intended valve performance (BEV: 27.6% versus SEV: 82.4%;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.001), with lower mean gradients (BEV: 20\u00b19 versus SEV: 13\u00b19 mm\u2009Hg;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.002), and larger indexed effective orifice area (BEV: 0.69\u00b10.27 versus SEV: 0.93\u00b10.32 cm\n                      <jats:sup>2<\/jats:sup>\n                      \/m\n                      <jats:sup>2<\/jats:sup>\n                      ;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.002). The rate of moderate aortic regurgitation was 0% in the BEV group versus 2.9% in the SEV group (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.582). Functional status and quality of life improved similarly in both groups. No differences were observed in the composite end point of death, stroke, or heart failure\u2013related hospitalization (BEV: 32.6% versus SEV: 25.5%;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.489). Mortality was also not statistically different between groups (BEV: 23.3% versus SEV: 15.7%;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.375). No significant differences were observed in other adverse events.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>In patients undergoing valve-in-valve TAVR for failed small aortic bioprostheses, SEV demonstrated a superior valve hemodynamic performance at 3-year follow-up, with similar clinical outcomes and functional improvement compared with BEV.<\/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: NCT03520101.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circinterventions.125.016255","type":"journal-article","created":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T10:00:14Z","timestamp":1770026414000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Balloon- Versus Self-Expanding Transcatheter Valves for Failed Small Surgical Aortic Bioprostheses: 3-Year Results of the LYTEN Trial"],"prefix":"10.1161","volume":"19","clinical-trial-number":[{"clinical-trial-number":"nct03520101","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8814-7039","authenticated-orcid":true,"given":"Pedro","family":"Cepas-Guill\u00e9n","sequence":"first","affiliation":[{"name":"Quebec Heart and Lung Institute, Cardiology Department, Laval University, Canada (P.C.-G., S.M., C.G., E.P.-B., P.P., J.R.-C.)."},{"name":"Clinic Cardiovascular Institute, Hospital Clinic de Barcelona, Cardiology Department, Institut d\u2019Investigacions Biom\u00e8diques August Pi i Sunyer, University of Barcelona, Spain (P.C.-G., A.R., J.R.-C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7316-4247","authenticated-orcid":true,"given":"Amr E.","family":"Abbas","sequence":"additional","affiliation":[{"name":"Corewell Health East, Cardiology Department, William Beaumont University Hospital, Royal Oak, MI (A.E.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vicen\u00e7","family":"Serra","sequence":"additional","affiliation":[{"name":"Hospital Universitari Vall d\u2019Hebron, Cardiology Department, Barcelona, Spain (V.S., A.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1767-5963","authenticated-orcid":true,"given":"Victoria","family":"Vilalta","sequence":"additional","affiliation":[{"name":"Hospital Universitari Germans Trias i Pujol, Badalona, Spain (V.V., E.F.-N.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3438-8907","authenticated-orcid":true,"given":"Luis","family":"Nombela-Franco","sequence":"additional","affiliation":[{"name":"Cardiovascular Institute, Hospital Cl\u00ednico San Carlos, Cardiology Department, Instituto de Investigaci\u00f3n Sanitaria del Hospital Cl\u00ednico San Carlos (IdISSC), Madrid, Spain (L.N.-F.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ander","family":"Regueiro","sequence":"additional","affiliation":[{"name":"Clinic Cardiovascular Institute, Hospital Clinic de Barcelona, Cardiology Department, Institut d\u2019Investigacions Biom\u00e8diques August Pi i Sunyer, University of Barcelona, Spain (P.C.-G., A.R., J.R.-C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0195-4984","authenticated-orcid":true,"given":"Karim M.","family":"Al-Azizi","sequence":"additional","affiliation":[{"name":"Baylor Scott and White the Heart Hospital Plano, Cardiology Department, TX (K.M.A.-A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayman","family":"Iskander","sequence":"additional","affiliation":[{"name":"St. Joseph\u2019s Health (SJH) Cardiology Associates, Cardiology Department, Syracuse, NY (A.I.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2237-9050","authenticated-orcid":true,"given":"Lenard","family":"Conradi","sequence":"additional","affiliation":[{"name":"University Heart and Vascular Center, Cardiology Department, Hamburg, Germany (L.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4753-2704","authenticated-orcid":true,"given":"Jessica","family":"Forcillo","sequence":"additional","affiliation":[{"name":"Centre Hospitalier Universitaire de Montr\u00e9al, Cardiology Department, Quebec, Canada (J.F.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2597-6806","authenticated-orcid":true,"given":"Scott","family":"Lilly","sequence":"additional","affiliation":[{"name":"The Ohio State University (OSU) Heart and Vascular Research Organization, Cardiology Department, Richard M. Ross Hospital, Columbus, OH (S.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8388-4988","authenticated-orcid":true,"given":"\u00c1lvaro","family":"Calabuig","sequence":"additional","affiliation":[{"name":"Hospital Universitari Vall d\u2019Hebron, Cardiology Department, Barcelona, Spain (V.S., A.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2219-921X","authenticated-orcid":true,"given":"Eduard","family":"Fernandez-Nofrerias","sequence":"additional","affiliation":[{"name":"Hospital Universitari Germans Trias i Pujol, Badalona, Spain (V.V., E.F.-N.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7622-4172","authenticated-orcid":true,"given":"Siamak","family":"Mohammadi","sequence":"additional","affiliation":[{"name":"Quebec Heart and Lung Institute, Cardiology Department, Laval University, Canada (P.C.-G., S.M., C.G., E.P.-B., P.P., J.R.-C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3157-4598","authenticated-orcid":true,"given":"Carlos","family":"Giuliani","sequence":"additional","affiliation":[{"name":"Quebec Heart and Lung Institute, Cardiology Department, Laval University, Canada (P.C.-G., S.M., C.G., E.P.-B., P.P., J.R.-C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-1454-2262","authenticated-orcid":true,"given":"Emilie","family":"Pelletier-Beaumont","sequence":"additional","affiliation":[{"name":"Quebec Heart and Lung Institute, Cardiology Department, Laval University, Canada (P.C.-G., S.M., C.G., E.P.-B., P.P., J.R.-C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3607-279X","authenticated-orcid":true,"given":"Philippe","family":"Pibarot","sequence":"additional","affiliation":[{"name":"Quebec Heart and Lung Institute, Cardiology Department, Laval University, Canada (P.C.-G., S.M., C.G., E.P.-B., P.P., J.R.-C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8237-7095","authenticated-orcid":true,"given":"Josep","family":"Rod\u00e9s-Cabau","sequence":"additional","affiliation":[{"name":"Quebec Heart and Lung Institute, Cardiology Department, Laval University, Canada (P.C.-G., S.M., C.G., E.P.-B., P.P., J.R.-C.)."},{"name":"Clinic Cardiovascular Institute, Hospital Clinic de Barcelona, Cardiology Department, Institut d\u2019Investigacions Biom\u00e8diques August Pi i Sunyer, University of Barcelona, Spain (P.C.-G., A.R., J.R.-C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.shj.2024.100318"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehaa544"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1253\/circj.CJ-18-0157"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2024.08.032"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2022.05.005"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2023.10.028"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehs255"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2021.02.038"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.118.038408"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2017.08.059"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2019.12.026"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2024.09.007"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2312573"},{"key":"e_1_3_3_15_2","unstructured":"Herrmann HC. 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