{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T21:05:53Z","timestamp":1792789553855,"version":"4.5.0"},"reference-count":33,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2023,2,1]],"date-time":"2023-02-01T00:00:00Z","timestamp":1675209600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"CAMS Innovation Fund for Medical Sciences","award":["2021-I2M-C&T-A-010"],"award-info":[{"award-number":["2021-I2M-C&T-A-010"]}]},{"name":"CAMS Innovation Fund for Medical Sciences","award":["2020YFC2008100"],"award-info":[{"award-number":["2020YFC2008100"]}]},{"name":"CAMS Innovation Fund for Medical Sciences","award":["NCT05044377"],"award-info":[{"award-number":["NCT05044377"]}]},{"name":"National Key R&amp;D Program of China","award":["2021-I2M-C&T-A-010"],"award-info":[{"award-number":["2021-I2M-C&T-A-010"]}]},{"name":"National Key R&amp;D Program of China","award":["2020YFC2008100"],"award-info":[{"award-number":["2020YFC2008100"]}]},{"name":"National Key R&amp;D Program of China","award":["NCT05044377"],"award-info":[{"award-number":["NCT05044377"]}]},{"name":"Capital Health Research and Development of Special Fund Program","award":["2021-I2M-C&T-A-010"],"award-info":[{"award-number":["2021-I2M-C&T-A-010"]}]},{"name":"Capital Health Research and Development of Special Fund Program","award":["2020YFC2008100"],"award-info":[{"award-number":["2020YFC2008100"]}]},{"name":"Capital Health Research and Development of Special Fund Program","award":["NCT05044377"],"award-info":[{"award-number":["NCT05044377"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Introduction: Chronic severe aortic regurgitation (AR) has a poor long-term prognosis, especially among old-age patients. Considering their advancing age, the surgical approach of aortic valve replacement may not always be the best alternative modality of treatment in such patients. Therefore, this study\u2019s primary goal was to provide an initial summary of the medium- and short-term clinical effectiveness of transcatheter aortic valve replacement (TAVR) guided by accurate multi-detector computed tomography (MDCT) measurements in patients with severe and chronic AR, especially in elderly patients. Methods: The study enrolled retrospectively and prospectively patients diagnosed with severe AR who eventually underwent TAVR procedure from January 2019 to September 2022 at Fuwai cardiovascular Hospital, Beijing. Baseline information, MDCT measurements, anatomical classification, perioperative, and 1-year follow-up outcomes were collected and analyzed. Based on a novel anatomical categorization and dual anchoring theory, patients were divided into four categories according to the level of anchoring area. Type 1, 2, and 3 patients (with at least two anchoring regions) will receive TAVR with a transcatheter heart valve (THV), but Type 4 patients (with zero or one anchoring location) will be deemed unsuitable for TAVR and will instead receive medical care (retrospectively enrolled patients who already underwent TAVR are an exception). Results: The mean age of the 37 patients with severe chronic AR was 73.1 \u00b1 8.7 years, and 23 patients (62.2%) were male. The American Association of Thoracic Surgeons\u2019 score was 8.6 \u00b1 2.1%. The MDCT anatomical classification included 17 cases of type 1 (45.9%), 3 cases of type 2 (8.1%), 13 cases of type 3 (35.1%), and 4 cases of Type 4 (10.8%). The VitaFlow valve (MicroPort, Shanghai, China) was implanted in 19 patients (51.3%), while the Venus A valve (Venus MedTech, Hangzhou, China) was implanted in 18 patients (48.6%). Immediate TAVR procedural and device success rates were 86.5% and 67.6%, respectively, while eight cases (21.6%) required THV-in-THV implantation, and nine cases (24.3%) required permanent pacemaker implantation. Univariate regression analysis revealed that the major factors affecting TAVR device failure were sinotubular junction diameter, THV type, and MDCT anatomical classification (p &lt; 0.05). Compared with the baseline, the left ventricular ejection fraction gradually increased, while the left ventricular end-diastolic diameter remained small, and the N-terminal-pro hormone B-type natriuretic peptide level significantly decreased within one year. Conclusion: According to the results of our study, TAVR with a self-expanding THV is safe and feasible for patients with chronic severe AR, particularly for those who meet the criteria for the appropriate MDCT anatomical classification with intact dual aortic anchors, and it has a significant clinical effect for at least a year.<\/jats:p>","DOI":"10.3390\/jcm12031157","type":"journal-article","created":{"date-parts":[[2023,2,1]],"date-time":"2023-02-01T05:57:56Z","timestamp":1675231076000},"page":"1157","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Can Measuring the \u2018Dual Anchors of Aorta\u2019 Enhance the Success Rate of TAVR?\u2014A Single-Center Experience"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5911-8300","authenticated-orcid":false,"given":"Yang","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Science and Peking Union Medical College, 167 Beilishilu, Xicheng District, Beijing 100037, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Md Misbahul","family":"Ferdous","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Science and Peking Union Medical College, 167 Beilishilu, Xicheng District, Beijing 100037, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lakshme","family":"Kottu","sequence":"additional","affiliation":[{"name":"Department of Experimental Cardiology, Erasmus University Medical Center, 3015 CE Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Science and Peking Union Medical College, 167 Beilishilu, Xicheng District, Beijing 100037, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hong-Liang","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Science and Peking Union Medical College, 167 Beilishilu, Xicheng District, Beijing 100037, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mo-Yang","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Science and Peking Union Medical College, 167 Beilishilu, Xicheng District, Beijing 100037, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guan-Nan","family":"Niu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Science and Peking Union Medical College, 167 Beilishilu, Xicheng District, Beijing 100037, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qing-Rong","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Science and Peking Union Medical College, 167 Beilishilu, Xicheng District, Beijing 100037, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zheng","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Science and Peking Union Medical College, 167 Beilishilu, Xicheng District, Beijing 100037, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhen-Yan","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Science and Peking Union Medical College, 167 Beilishilu, Xicheng District, Beijing 100037, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qian","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Science and Peking Union Medical College, 167 Beilishilu, Xicheng District, Beijing 100037, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"De-Jing","family":"Feng","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Science and Peking Union Medical College, 167 Beilishilu, Xicheng District, Beijing 100037, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bin","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Science and Peking Union Medical College, 167 Beilishilu, Xicheng District, Beijing 100037, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zi-Ang","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Science and Peking Union Medical College, 167 Beilishilu, Xicheng District, Beijing 100037, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4852-831X","authenticated-orcid":false,"given":"Daphne","family":"Merkus","sequence":"additional","affiliation":[{"name":"Department of Experimental Cardiology, Erasmus University Medical Center, 3015 CE Rotterdam, The Netherlands"},{"name":"Walter-Brendel-Centre of Experimental Medicine, Ludwig-Maximilians-University M\u00fcnchen, 81377 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1744-7584","authenticated-orcid":false,"given":"Bin","family":"Lv","sequence":"additional","affiliation":[{"name":"Department of Radiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Science and Peking Union Medical College, 167 Beilishilu, Xicheng District, Beijing 100037, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hai-Yan","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Science and Peking Union Medical College, 167 Beilishilu, Xicheng District, Beijing 100037, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guang-Yuan","family":"Song","sequence":"additional","affiliation":[{"name":"Interventional Center of Valvular Heart Disease, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong-Jian","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Science and Peking Union Medical College, 167 Beilishilu, Xicheng District, Beijing 100037, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,2,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1659","DOI":"10.1016\/j.jacc.2020.02.031","article-title":"Prognostic Value of N-Terminal Pro-B-Type Natriuretic Peptide in Elderly Patients With Valvular Heart 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