{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T02:45:54Z","timestamp":1789094754747,"version":"build-2803163510"},"reference-count":28,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"18","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2021,9,21]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">No study has evaluated the impact of the additional manipulation demanded by multiple resheathing (MR) in patients undergoing transcatheter aortic valve replacement with repositionable self\u2010expanding valves.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              This study included a real\u2010world, multicenter registry involving 16 centers from Canada, Germany, Latin America, and Spain. All consecutive patients who underwent transcatheter aortic valve replacement with the Evolut R, Evolut PRO, and Portico valves were included. Patients were divided according to the number of resheathing: no resheathing, single resheathing (SR), and MR. The primary end point was device success. Secondary outcomes included procedural complications, early safety events, and 1\u2010year mortality. In 1026 patients, the proportion who required SR and MR was 23.9% and 9.3%, respectively. MR was predicted by the use of Portico and moderate\/severe aortic regurgitation at baseline (both with\n              <jats:italic>P<\/jats:italic>\n              &lt;0.01). Patients undergoing MR had less device success (no resheathing=89.9%, SR=89.8%, and MR=80%;\n              <jats:italic>P<\/jats:italic>\n              =0.01), driven by more need for a second prosthesis and device embolization. At 30 days, there were no differences in safety events. At 1\u00a0year, more deaths occurred with MR (no resheathing=10.5%, SR=8.0%, and MR=18.8%;\n              <jats:italic>P<\/jats:italic>\n              =0.014). After adjusting for baseline differences and center experience by annual volume, MR associated with less device success (odds ratio, 0.42;\n              <jats:italic>P<\/jats:italic>\n              =0.003) and increased 1\u2010year mortality (hazard ratio, 2.06;\n              <jats:italic>P<\/jats:italic>\n              =0.01). When including only the Evolut R\/PRO cases (N=837), MR continued to have less device success (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001) and a trend toward increased mortality (\n              <jats:italic>P<\/jats:italic>\n              =0.05).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Repositioning a self\u2010expanding valve is used in a third of patients, being multiple in \u224810%. MR, but not SR, was associated with more device failure and higher 1\u2010year mortality, regardless of the type of valve implanted.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.120.020682","type":"journal-article","created":{"date-parts":[[2021,9,3]],"date-time":"2021-09-03T09:25:50Z","timestamp":1630661150000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":11,"title":["Incidence, Predictor, and Clinical Outcomes of Multiple Resheathing With Self\u2010Expanding Valves During Transcatheter Aortic Valve Replacement"],"prefix":"10.1161","volume":"10","author":[{"given":"Fernando L. M.","family":"Bernardi","sequence":"first","affiliation":[{"name":"Instituto do Cora\u00e7\u00e3o Hospital das Clinicas HCFMUSP Faculdade de MedicinaUniversidade de Sao Paulo Sao Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8237-7095","authenticated-orcid":false,"given":"Josep","family":"Rod\u00e9s\u2010Cabau","sequence":"additional","affiliation":[{"name":"Quebec Heart and Lung InstituteLaval University Quebec City Quebec Canada"},{"name":"Hospital Cl\u00ednic de Barcelona Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriela","family":"Tirado\u2010Conte","sequence":"additional","affiliation":[{"name":"Cardiovascular InstituteHospital Cl\u00ednico San Carlos Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ignacio J.","family":"Amat Santos","sequence":"additional","affiliation":[{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades CardiovascularesHospital Cl\u00ednico Universitario de Valladolid Valladolid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Plachtzik","sequence":"additional","affiliation":[{"name":"Karl\u2010Olga Krankenhaus Stuttgard Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernando","family":"Cura","sequence":"additional","affiliation":[{"name":"Instituto Cardiovascular de Buenos Aires Buenos Aires Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matias","family":"Sztejfman","sequence":"additional","affiliation":[{"name":"Sanatorio Finochietto Buenos Aires Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernanda M.","family":"Mangione","sequence":"additional","affiliation":[{"name":"Hospital Benefic\u00eancia Portuguesa S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rog\u00e9rio","family":"Tumeleiro","sequence":"additional","affiliation":[{"name":"Hospital S\u00e3o Vicente de Paulo Passo Fundo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vinicius Borges Cardozo","family":"Esteves","sequence":"additional","affiliation":[{"name":"Rede Dor S\u00e3o Luiz S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduardo Fran\u00e7a","family":"Pessoa de Melo","sequence":"additional","affiliation":[{"name":"Hospital Esperan\u00e7a Olinda Rede D'Or S\u00e3o Luiz Recife Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alejandro","family":"Alcocer Chauvet","sequence":"additional","affiliation":[{"name":"Hospital Regional 1\u00ba de Octubre Mexico City Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felipe","family":"Fuchs","sequence":"additional","affiliation":[{"name":"Hospital de Cl\u00ednicas de Porto Alegre Porto Alegre Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rogerio","family":"Sarmento\u2010Leite","sequence":"additional","affiliation":[{"name":"Instituto de Cardiologia de Porto Alegre Porto Alegre Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Est\u00eav\u00e3o Carvalho","family":"de Campos Martins","sequence":"additional","affiliation":[{"name":"Hospital de For\u00e7a A\u00e9rea do Gale\u00e3o Rio de Janeiro Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3438-8907","authenticated-orcid":false,"given":"Luis","family":"Nombela\u2010Franco","sequence":"additional","affiliation":[{"name":"Cardiovascular InstituteHospital Cl\u00ednico San Carlos Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Raul","family":"Delgado\u2010Arana","sequence":"additional","affiliation":[{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades CardiovascularesHospital Cl\u00ednico Universitario de Valladolid Valladolid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wolfgang","family":"Bocksch","sequence":"additional","affiliation":[{"name":"Karl\u2010Olga Krankenhaus Stuttgard Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pablo","family":"Lamelas","sequence":"additional","affiliation":[{"name":"Instituto Cardiovascular de Buenos Aires Buenos Aires Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3157-4598","authenticated-orcid":false,"given":"Carlos","family":"Giuliani","sequence":"additional","affiliation":[{"name":"Sanatorio Finochietto Buenos Aires Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diego Carter","family":"Campanha\u2010Borges","sequence":"additional","affiliation":[{"name":"Instituto do Cora\u00e7\u00e3o Hospital das Clinicas HCFMUSP Faculdade de MedicinaUniversidade de Sao Paulo Sao Paulo Brazil"},{"name":"Hospital Samaritano Paulista S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4784-1152","authenticated-orcid":false,"given":"Jose A.","family":"Mangione","sequence":"additional","affiliation":[{"name":"Hospital Benefic\u00eancia Portuguesa S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr","given":"F\u00e1bio Sandoli","family":"de Brito","sequence":"additional","affiliation":[{"name":"Instituto do Cora\u00e7\u00e3o Hospital das Clinicas HCFMUSP Faculdade de MedicinaUniversidade de Sao Paulo Sao Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandre C.","family":"Abizaid","sequence":"additional","affiliation":[{"name":"Instituto do Cora\u00e7\u00e3o Hospital das Clinicas HCFMUSP Faculdade de MedicinaUniversidade de Sao Paulo Sao Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1273-1823","authenticated-orcid":false,"given":"Henrique B.","family":"Ribeiro","sequence":"additional","affiliation":[{"name":"Instituto do Cora\u00e7\u00e3o Hospital das Clinicas HCFMUSP Faculdade de MedicinaUniversidade de Sao Paulo Sao Paulo Brazil"},{"name":"Hospital Samaritano Paulista S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1814052"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1008232"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1103510"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1700456"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1400590"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1816885"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2012.02.022"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.01.047"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2016.05.059"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2019.05.056"},{"key":"e_1_3_1_12_2","first-page":"282","article-title":"Impact of repositioning during transcatheter aortic valve replacement on embolized debris","volume":"31","author":"Seeger J","year":"2019","unstructured":"Seeger J, Romero M, Schuh C, Virmani R, W\u00f6hrle J. Impact of repositioning during transcatheter aortic valve replacement on embolized debris. J Invasive Cardiol. 2019;31:282\u2013288.","journal-title":"J Invasive Cardiol"},{"key":"e_1_3_1_13_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehs255"},{"key":"e_1_3_1_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcha.2019.100462"},{"key":"e_1_3_1_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2020.04.028"},{"key":"e_1_3_1_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2017.10.014"},{"key":"e_1_3_1_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.09.014"},{"key":"e_1_3_1_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2017.05.021"},{"key":"e_1_3_1_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2016.08.050"},{"key":"e_1_3_1_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2017.06.045"},{"key":"e_1_3_1_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2016.11.025"},{"key":"e_1_3_1_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2015.05.015"},{"key":"e_1_3_1_23_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.130.suppl_2.16952"},{"key":"e_1_3_1_24_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.116.002756"},{"key":"e_1_3_1_25_2","doi-asserted-by":"publisher","DOI":"10.1155\/2019\/1906814"},{"key":"e_1_3_1_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)31358-1"},{"key":"e_1_3_1_27_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehz429"},{"key":"e_1_3_1_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.04.037"},{"key":"e_1_3_1_29_2","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.25778"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.120.020682","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T11:41:51Z","timestamp":1715600511000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.120.020682"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,9,21]]},"references-count":28,"journal-issue":{"issue":"18","published-print":{"date-parts":[[2021,9,21]]}},"alternative-id":["10.1161\/JAHA.120.020682"],"URL":"https:\/\/doi.org\/10.1161\/jaha.120.020682","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,9,21]]},"assertion":[{"value":"2020-12-30","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-06-14","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-09-03","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e020682"}}