ArticleClinical research in cardiology : official journal of the German Cardiac Society2021
Transcatheter aortic valve implantation in patients with a small aortic annulus: performance of supra-, intra- and infra-annular transcatheter heart valves.
Article in Clinical research in cardiology : official journal of the German Cardiac Society, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
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Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it, 34 citations in OpenAlex.
- Self-expanding or balloon-expandable transcatheter aortic valve replacement in patients with small aortic annulus: A systematic review and meta-analysis.Indian heart journalPooled it
- Balloon-Expandable Versus Self-Expandable Transcatheter Aortic Valve Implantation Devices: A Contemporary Systematic Review.Journal of clinical medicine · 2026Review
- Outcomes of Transcatheter Aortic Valve Implantation with Abbott's Portico Compared to Edwards' SAPIEN 3: A Systematic Review and Meta-Analysis.Journal of clinical medicine · 2026Review
- Analysis of aortic valve prostheses using advanced cardiovascular imaging-a patient-specific reversed translational approach.Scientific reports · 2026Article
- Lifetime Management of Aortic Stenosis: Evolving Strategies and Personalized Decision-Making.Journal of clinical medicine · 2026Review
- Clinical evaluation of the Hydra self-expanding THV: 30-day results from the GENESIS-II study.AsiaIntervention · 2025Article
- Procedural Strategies in Transcatheter Aortic Valve Replacement for Patients With Small Aortic Annulus and Aortic Stenosis.JACC. Case reports · 2025Article
- Case Report: A case of transcatheter aortic valve replacement in a patient with a small aortic annulus using the Acurate Neo2.Frontiers in cardiovascular medicine · 2025Article
- Short and Long-Term Outcomes of Transcatheter Aortic Valve Implantation in the Small Aortic Annulus: A Systematic Literature Review.Journal of personalized medicine · 2024Review
- Transcatheter Aortic Valve Replacement for Failed Surgical or Transcatheter Bioprosthetic Valves: A Comprehensive Review.Journal of clinical medicine · 2024Review
- Valve Hemodynamics by Valve Size and 1-Year Survival Following Implantation of the Portico Valve in the Multicenter CONFIDENCE Registry.Structural heart : the journal of the Heart Team · 2024Article
- Multicenter comparison of transcatheter aortic valve implantation with the self-expanding ACURATE neo2 versus Evolut PRO transcatheter heart valves.Clinical research in cardiology : official journal of the German Cardiac Society · 2024Article
- Transcatheter aortic valve implantation in patients with extra-small aortic annuli.EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · 2023Article
- Implantation of contemporary transcatheter aortic valves in small aortic annuli: the international multicentre TAVI-SMALL 2 registry.EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · 2023Article
- Valve-in-valve procedures for degenerated surgical and transcatheter aortic valve bioprostheses using a latest-generation self-expanding intra-annular transcatheter heart valve.Frontiers in cardiovascular medicine · 2023Article
- Case report: Self-expanding transcatheter valve implantation (Acurate Neo 2) in a very small native aortic annulus.Frontiers in cardiovascular medicine · 2023Article
- Procedural Outcomes of a Self-Expanding Transcatheter Heart Valve in Small Annuli.Journal of clinical medicine · 2022Article
- Technical Aspects and Development of Transcatheter Aortic Valve Implantation.Journal of cardiovascular development and disease · 2022Review
Corrections and comments
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Authors and funding
18 authors at 5 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundA small aortic annulus is associated with increased risk of prosthesis-patient mismatch (PPM) after transcatheter aortic valve implantation (TAVI). Whether specific transcatheter heart valve (THV) designs yield superior hemodynamic performance in these small anatomies remains unclear.
methodsData from 8411 consecutive patients treated with TAVI from May 2012 to April 2019 at four German centers were retrospectively evaluated. A small aortic annulus was defined as multidetector computed tomography-derived annulus area < 400 mm
resultsA small annulus was found in 1069 (12.7%) patients. PPM was detected in 38.3% overall with a higher prevalence after implantation of a balloon-expanding intra-annular or mechanically expanding infra-annular THV compared to self-expanding intra- and supra-annular THV. Multivariable analysis linked self-expanding THV (Evolut: Odds ratio [OR] 0.341, Acurate-Neo: OR 0.436, Portico: OR 0.291), postdilatation (OR 0.648) and age (OR 0.968) to lower rates of PPM, while aortic valve calcification was associated with an increased risk (OR 1.001). Paravalvular regurgitation > mild was more frequent after TAVI with self-expanding THV (p = 0.04).
conclusionIn this large contemporary multicenter patient population, a substantial number of patients with a small aortic anatomy were left with PPM after TAVI. Self-expanding supra- and intra-annular THV demonstrated superior hemodynamics in these patients at risk, however at the cost of higher rates of residual paravalvular regurgitation.
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