Evidence map›Paper›PMID 41496753›Full record

ArticleStructural heart : the journal of the Heart Team2025

Self-Expandable Transcatheter Aortic Valves in Patients With Small Aortic Annulus: The SWEDEHEART Registry.

Antros Louca, Anna Myredal, Monér Alchay, Henrik Hagström, Dan Ioanes, Stefan James, Sasha Koul, Araz Rawshani, Björn Redfors, Andreas Rück and 5 more

Abstract read
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In one paragraph

Article in Structural heart : the journal of the Heart Team, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Antros LoucaDepartment of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
Anna MyredalDepartment of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
Monér AlchayDepartment of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
Henrik HagströmDepartment of Public Health and Clinical Medicine, Umeå University, Umeå.
Dan IoanesDepartment of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden.
Stefan JamesDepartment of Medical Sciences, Cardiology, Uppsala University, Uppsala, Sweden.
Sasha KoulDepartment of Clinical Sciences, Cardiology, Lund University Hospital, Lund, Sweden.
Araz RawshaniDepartment of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
Björn RedforsDepartment of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
Andreas RückDepartment of Cardiology, Karolinska University Hospital and Karolinska Institute, Stockholm, Sweden.
Kristofer SkoglundDepartment of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
Sebastian VölzDepartment of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
Petur PeturssonDepartment of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
Truls RåmunddalDepartment of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
Oskar AngeråsDepartment of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Small aortic annulus is associated with poorer hemodynamic outcomes in transcatheter aortic valve replacement (TAVR). In these cases, supra-annular (SA) self-expandable valves (SEVs) may offer better results than intra-annular SEVs (IA SEVs). This study evaluated clinical and hemodynamic outcomes for SA SEVs (Evolut valves, Acurate valves) and IA SEVs (Portico/Navitor valves). Methods: We analyzed data from patients who underwent TAVR in Sweden between 2013 and 2022 with an annular diameter ≤23 mm, using inverse probability of treatment weighting. Endpoints included mortality, device, and technical success as per Valve Academic Research Consortium 3 definitions. Other endpoints were the incidence of post-TAVR mean or peak gradients over 20 and 40 mmHg, respectively, significant paravalvular leakage, new pacemaker implantation, and postprocedural aortic valve gradients. Results: The study included 1068 patients, with a median age of 81.2 years, and 88% were women. After inverse probability of treatment weighting adjustment, no differences were observed in the outcomes apart from a marginally lower risk of postprocedural mortality in the Portico/Navitor valves compared to the Evolut valves (adjusted odds ratio: 0.99; Conclusions: SA and IA SEVs show comparable clinical outcomes and excellent hemodynamic performance in patients with small aortic annuli. Further studies, including randomized trials, are needed to provide clearer guidance on valve selection.

Indexed as

Aortic valve stenosisSelf-expandable valvesSmall aortic annulusTranscatheter aortic valve replacement

Identifiers

PMID41496753
PMCPMC12766495

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.