{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T07:03:40Z","timestamp":1789715020495,"version":"4.0.1"},"reference-count":30,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,5,19]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">The use of balloon\u2010expandable valves (BEVs) or self\u2010expanding valves (SEVs) for transcatheter aortic valve replacement (TAVR) in patients with low\u2010flow, low\u2010gradient aortic stenosis (LFLG\u2010AS) has been poorly investigated. Aim of this study is to evaluate the procedural and clinical outcomes of patients with severe low\u2010flow, low\u2010gradient aortic stenosis undergoing TAVR with current\u2010generation prostheses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">This registry\u2010based, multicenter, cohort study included consecutive patients with low\u2010flow, low\u2010gradient aortic stenosis undergoing TAVR from January 2019 to December 2024 at 17 high\u2010volume Italian centers. The study population was divided into 2 groups according to the use of BEVs or SEVs. The primary outcome was all\u2010cause mortality up to 1\u2009year.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      The study involved 1380 patients; 592 (42.9%) underwent TAVR with BEVs, and 788 (57.1%) with SEVs. At discharge, BEVs were linked to higher mean transvalvular gradients (\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001) and a higher percentage of moderate predicted patient\u2010prosthesis mismatch (\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001) compared with SEVs. After propensity score weighting, the Cox analysis showed no difference for the risk of the primary outcome (adjusted hazard ratio [HR]:1.23; 95% CI: 0.88\u20131.72), cardiovascular mortality (adjusted HR:1.37; 95% CI: 0.94\u20131.97), stroke (adjusted HR:1.83; 95% CI: 0.85\u20133.95), and myocardial infarction (adjusted HR:1.03; 95% CI: 0.40\u20132.69) between groups; however, the use of BEVs was associated with a significantly higher risk for HF hospitalization up to 1\u2009year (adjusted HR: 1.54; 95% CI:1.05\u20132.25).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">In this real\u2010world study on TAVR treatment for patients with low\u2010flow, low\u2010gradient aortic stenosis, there was no difference in mortality rates between BEVs and SEVs up to 1\u2009year. However, the use of BEVs was linked to less favorable hemodynamic performance and a higher risk of HF hospitalization.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Registration<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      URL:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/clinicaltrials.gov\/\">https:\/\/clinicaltrials.gov\/<\/jats:ext-link>\n                      ; Unique identifier: NCT06589063.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.046441","type":"journal-article","created":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T11:11:11Z","timestamp":1778757071000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Balloon\u2010Expandable Versus Self\u2010Expanding Prostheses for Transcatheter Treatment of Patients With Low\u2010Flow, Low\u2010Gradient Aortic Stenosis"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9410-6321","authenticated-orcid":false,"given":"Germano Junior","family":"Ferruzzi","sequence":"first","affiliation":[{"name":"University of Salerno","place":["Baronissi (Salerno), Italy"]},{"name":"University Hospital San Giovanni di Dio e Ruggi d'Aragona","place":["Salerno, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9792-7782","authenticated-orcid":false,"given":"Michele","family":"Bellino","sequence":"additional","affiliation":[{"name":"University of Salerno","place":["Baronissi (Salerno), Italy"]},{"name":"University Hospital San Giovanni di Dio e Ruggi d'Aragona","place":["Salerno, 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