{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T12:14:26Z","timestamp":1791980066203,"version":"4.4.0"},"reference-count":30,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,1,6]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Self\u2010expanding valves (SEVs) have demonstrated superior hemodynamic performance and comparable clinical outcomes to balloon\u2010expandable valves (BEVs) at 1\u2009year in patients with a small aortic annulus. However, long\u2010term data are limited. This study aimed to evaluate 5\u2010year echocardiographic and clinical outcomes of SEVs versus BEVs in patients with small aortic annulus underwent transcatheter aortic valve replacement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      We analyzed RESOLVE registry patients who underwent transcatheter aortic valve replacement at Cedars\u2010Sinai between 2015 and 2020. Patients with a small aortic annulus (&lt;430\u2009mm\n                      <jats:sup>2<\/jats:sup>\n                      by computed tomography) were included and followed for up to 5\u2009years. The primary outcome was a composite of all\u2010cause mortality, stroke, or heart failure hospitalization. Secondary outcomes included myocardial infarction, pacemaker implantation, aortic valve reintervention, and structural bioprosthetic valve dysfunction.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Among 1392 transcatheter aortic valve replacement recipients, 423 (78 SEVs, 345 BEVs) met the small annulus criteria. SEVs were associated with lower transvalvular gradients and larger indexed effective orifice area at discharge and 1\u2009year (\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001). Moderate\u2010to\u2010severe paravalvular leak was more frequent with SEVs at 30\u2009days (7.7% versus 1.5%,\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001), as was permanent pacemaker implantation (17.9% versus 6.1%,\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001). At 5\u2009years, the primary outcome did not differ significantly (hazard ratio, 1.21; 95% CI, 0.81\u20131.82;\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.33). All\u2010cause mortality, stroke, heart failure hospitalization, structural bioprosthetic valve dysfunction, and reintervention rates were similar between groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p xml:lang=\"en\">Although SEVs provide better hemodynamic performance in patients with severe aortic stenosis and small annuli, this advantage did not translate into improved survival or reduced cardiovascular events at 5\u2009years.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.045417","type":"journal-article","created":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T10:19:35Z","timestamp":1767089975000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Long\u2010Term Clinical Outcomes of Balloon\u2010Expandable Versus Self\u2010Expanding Transcatheter Aortic Valve Replacement in Patients With Small Aortic Annulus"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3606-6370","authenticated-orcid":false,"given":"Shubhadarshini","family":"Pawar","sequence":"first","affiliation":[{"name":"Cedars Sinai Medical Center","place":["Los Angeles, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7209-3531","authenticated-orcid":false,"given":"Vivek","family":"Patel","sequence":"additional","affiliation":[{"name":"Cedars Sinai Medical Center","place":["Los Angeles, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takashi","family":"Nagasaka","sequence":"additional","affiliation":[{"name":"Cedars Sinai Medical Center","place":["Los Angeles, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prateek","family":"Madaan","sequence":"additional","affiliation":[{"name":"Cedars Sinai Medical Center","place":["Los Angeles, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amir Ghaffari","family":"Jolfayi","sequence":"additional","affiliation":[{"name":"Cedars Sinai Medical Center","place":["Los Angeles, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ofir","family":"Koren","sequence":"additional","affiliation":[{"name":"Cedars Sinai Medical Center","place":["Los Angeles, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dhairya","family":"Patel","sequence":"additional","affiliation":[{"name":"Cedars Sinai Medical Center","place":["Los Angeles, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tarun","family":"Chakravarty","sequence":"additional","affiliation":[{"name":"Cedars Sinai Medical Center","place":["Los Angeles, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-5586-3880","authenticated-orcid":false,"given":"Mamoo","family":"Nakamura","sequence":"additional","affiliation":[{"name":"Cedars Sinai Medical Center","place":["Los Angeles, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen","family":"Cheng","sequence":"additional","affiliation":[{"name":"Cedars Sinai Medical Center","place":["Los Angeles, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0141-9546","authenticated-orcid":false,"given":"Sabah","family":"Skaf","sequence":"additional","affiliation":[{"name":"Cedars Sinai Medical Center","place":["Los Angeles, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8397-9431","authenticated-orcid":false,"given":"Hasan","family":"Jilaihawi","sequence":"additional","affiliation":[{"name":"Cedars Sinai Medical Center","place":["Los Angeles, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raj R.","family":"Makkar","sequence":"additional","affiliation":[{"name":"Cedars Sinai Medical Center","place":["Los Angeles, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9103-9872","authenticated-orcid":false,"given":"Aakriti","family":"Gupta","sequence":"additional","affiliation":[{"name":"Cedars Sinai Medical Center","place":["Los Angeles, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1008232"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1103510"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1400590"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1514616"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1700456"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1814052"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1816885"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2312573"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2019.07.027"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2024.3241"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2019.12.026"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2022.08.057"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2018.04.010"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1111\/joic.12389"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2023.07.100"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)30757-2"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2021.02.038"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2015.01.023"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezx244"},{"key":"e_1_3_2_21_2","volume-title":"Cardiovascular 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