Larger Annulus Research Articles

Cooling of an integrated Brillouin laser below the thermal limit.

Photonically integrated resonators are promising as a platform for enabling ultranarrow linewidth lasers in a compact form factor. Owing to their small size, these integrated resonators suffer from thermal noise that limits the frequency stability of the optical mode to ∼100 kHz. Here, we demonstrate an integrated stimulated Brillouin scattering (SBS) laser based on a large mode-volume annulus resonator that realizes an ultranarrow thermal-noise-limited linewidth of 270 Hz. In practice, yet narrower linewidths are required before integrated lasers can be truly useful for applications such as optical atomic clocks, quantum computing, gravitational wave detection, and precision spectroscopy. To this end, we employ a thermorefractive noise suppression technique utilizing an auxiliary laser to reduce our SBS laser linewidth to 70 Hz. This demonstration showcases the possibility of stabilizing the thermal motion of even the narrowest linewidth chip lasers to below 100 Hz, thereby opening the door to making integrated microresonators practical for the most demanding future scientific endeavors.

Three-dimensional transesophageal echocardiographic morphological evaluation of the tricuspid valve.

OBJECTIVESThe morphology of the tricuspid valve (TV), particularly valves with two posterior leaflets, is attracting attention. The present study was performed to investigate the usefulness of three-dimensional transoesophageal echocardiographic data for morphological evaluation of the TV .METHODSSixty patients underwent morphological evaluation of the TV by preoperative transoesophageal echocardiography followed by TV repair with median sternotomy, and each leaflet was measured intraoperatively. We analysed the TV morphology in 51 patients whose preoperative echocardiographic findings were consistent with intraoperative findings.RESULTSThe mid-systolic echo data, which included the annulus diameter of each leaflet, were correlated with the intraoperative evaluation findings compared with those in the mid-diastole. The annulus and area of the posterior leaflet were larger in patients with two than one posterior leaflet valve (42.4 ± 13.5 vs 30.7 ± 9.1 mm, P < 0.001 and 327 ± 185 vs 208 ± 77 mm2, P = 0.006, respectively). In the severe tricuspid regurgitation patients, the annulus of the posterior leaflet was larger and the annulus of the anterior leaflet was smaller in patients with two than one posterior leaflet valve [posterior: 48 mm [95% confidence interval (CI), 41–54 mm] vs 36 mm (95% CI, 27–45 mm), respectively; P = 0.043 and anterior: 38 mm (95% CI, 33–42 mm) vs 46 mm (95% CI, 40–52 mm), respectively; P = 0.025].CONCLUSIONSPatients who had a TV with two posterior leaflets had a larger annulus and area of the posterior leaflets. Preoperative three-dimensional transoesophageal echocardiography is useful for the morphological evaluation of the TV.

Interpolation of power mappings

Let (M_j)_{j=1}^\infty\in\mathbb{N} and (r_j)_{j=1}^\infty\in\mathbb{R}^+ be increasing sequences satisfying some mild rate of growth conditions. We prove that there exists an entire function f\colon \mathbb{C} \rightarrow\mathbb{C} whose behavior in the large annuli \{ z\in\mathbb{C} : r_{j}\cdot\exp(\pi/M_{j})\leq|z|\leq r_{j+1}\} is given by a perturbed rescaling of z\mapsto z^{M_j} , such that the only singular values of f are rescalings of \pm r_j^{M_j} . We describe several applications to the dynamics of entire functions.

Clinical, functional and prognostic implications of severe atrial dilation in secondary mitral regurgitation

ObjectiveAtrial dilation is known to be a poor prognostic indicator. However, its clinical, functional and prognostic implications have not been thoroughly explored in secondary mitral regurgitation (SMR). We sought to...

Removing cuttings from inclined and horizontal wells: Numerical analysis of the required drilling fluid rheology and flow rate

Inclined and horizontal wells are prone to the accumulation of drilling cuttings. Determination of the optimal drilling parameters that facilitate cuttings removal is a key problem. Existing experimental, theoretical and field-based empirical analyses of the hole cleaning problem have failed to fully reveal the processes of cuttings transport, settlement, and accumulation concerning drilling string rotation in large annuli with high-density non-Newtonian drilling fluids. In this study, a coupled computational fluid dynamics-discrete element method (CFD-DEM) simulation model of the interaction between cuttings and drilling fluid was established. This allows the influences of well inclination, drill pipe rotational rate, flow rate, fluid density, and rheological properties on hole cleaning efficiency to be analyzed. A multi-parameter correlation equation between wellbore cleaning efficiency and wellbore size, inclination angle, drill string eccentricity, drill string rotational speed, rate of penetration, cuttings size, flow rate, and fluid density was obtained using dimensional analysis and multivariate nonlinear regression of simulation data. Finally, with consideration of wellbore cleaning characteristics, formation pressure bearing capacity, and pump condition constraints, the proposed multi-parameter correlation model was used to provide optimal wellbore cleaning parameters. The cleaning efficiency of horizontal wells is lowest in the inclined section. Hole cleaning efficiency increases significantly with drill pipe rotational rate, flow rate, and 6 RPM Fann dial reading. The proposed model can correlate hole cleaning efficiency with the 6 RPM Fann dial reading of drilling fluid and flow rate. At a given hole cleaning efficiency, the required minimum flow rate decreases with increases in the 6 RPM Fann dial reading. Similarly, the required minimum 6 RPM Fann dial reading decreases with increases in flow rate. The models and design layout proposed in this paper provide a new approach to solving hole cleaning parameter design problems in highly inclined and horizontal wells.

Repair of Mitral Valves with Severe Annular Dilatation and Abundant Leaflet Tissue Using a Prosthetic Ring with a Large Anterior-Posterior Diameter.

Backround: Mitral valve (MV) repair in the case of a large anterior-posterior diameter and redundant valve tissue remains challenging and favors repair with a ring that exhibits a large anterior-posterior diameter. Compared to other available rings, the Medtronic Simulus annuloplasty ring shows the largest anterior-posterior diameter. This study reports for the first time mid-term results using this annuloplasty ring. Methods: Between 11/2015 and 12/2019, a total of 378 patients underwent MV repair for degenerative mitral regurgitation using the Medtronic Simulus ring, according to the following selection criteria: large MV annuli, abundant leaflet tissue (i.e., Barlow disease), and risk for SAM. Results: Overall survival after 5 years was 90.8 ± 4.6%. Five patients required valve-related reoperations because of ring dehiscence (n = 1), progression of native valve disease (n = 2), dehiscence of quadrangular resection suture (n = 1), and endocarditis (n = 1). The cumulative incidence of valve-related reoperation at 5 years was 1.3 ± 0.5%. At latest follow-up, echocardiography demonstrated excellent valve function with no/mild MR in 299 patients (94.6%). Two patients (0.6%) had more than moderate MR. No patient developed SAM after repair. Conclusion: Repair of MV with large annuli and abundant leaflet tissue with the Medtronic Simulus annuloplasty ring shows excellent mid-term results regarding reoperation rates and recurrent MR.

The PARTNER 3 Bicuspid Registry forTranscatheter Aortic Valve Replacement in Low-Surgical-Risk Patients.

The study compared 1-year outcomes between transcatheter aortic valve replacement (TAVR) patientswith bicuspid aortic valve (BAV) morphology and clinically similar patients having tricuspid aortic valve (TAV) morphology. There are limited prospective data on TAVR using the SAPIEN 3 device in low-surgical-risk patientswithsevere, symptomatic aortic stenosis and bicuspid anatomy. Low-risk, severe aortic stenosis patients with BAV were candidates for the PARTNER 3 (Placement ofAorticTranscatheter Valves 3) (P3) bicuspid registry or the P3 bicuspid continued access protocol. Patients treated in these registries were pooled and propensity score matched to TAV patients from the P3 randomized TAVR trial. Outcomes were compared between groups. The primary endpoint was the 1-year composite rate of death, stroke, and cardiovascular rehospitalization. Of 320 total submitted BAV patients, 169 (53%) were treated, and most were Sievers type 1. Theremaining 151 patients were excluded caused by anatomic or clinical criteria. Propensity score matching with the P3 TAVR cohort (496 patients) yielded 148 pairs. There were no differences in baseline clinical characteristics; however, BAV patients had larger annuli and they experienced longer procedure duration. There was no difference in the primary endpoint between BAV and TAV (10.9% vs 10.2%; P = 0.80) or in the rates of the individual components (death: 0.7% vs 1.4%; P = 0.58; stroke: 2.1% vs 2.0%; P = 0.99; cardiovascular rehospitalization: 9.6% vs 9.5%; P= 0.96). Among highly select bicuspid aortic stenosis low-surgical-risk patients without extensive raphe or subannular calcification, TAVR with the SAPIEN 3 valve demonstrated similar outcomes to a matched cohort of patientswith tricuspid aortic stenosis.

90 Annular size and interaction with trans-catheter aortic valves for the treatment of severe bicuspid aortic valve stenosis: insights from the beat registry

Abstract Aims Transcatheter aortic valve replacement (TAVR) is safe and feasible in patients with bicuspid aortic valve (BAV), but whether annular size may influence TAVR results in BAV patients remains unclear. We aimed at evaluating the impact of aortic annular size on procedural and clinical outcomes of BAV patients undergoing TAVR, as well as potential interactions between annular dimension and trans-catheter heart valve (THV) type [balloon-expandable (BEV) vs. self-expanding (SEV)]. Methods and results BEAT is a multicentre registry of consecutive BAV stenosis undergoing TAVR. For this sub-study patients were classified according to annular dimension in small-annulus (area &amp;lt; 400 mm2 or perimeter &amp;lt;72 mm), medium-annulus (area ≥ 400 and &amp;lt; 575 mm2, perimeter ≥72 mm and&amp;lt; 85 mm), large-annulus (area ≥575 mm2 or perimeter ≥85 mm). Primary endpoint was Valve Academic Research Consortium-2 (VARC-2) device success. 45(15.5%) patients had small, 132(45.3%) medium, and 114(39.2%) large annuli. Compared with other groups, patients with large annuli were more frequently male, at younger age, had higher body mass index, larger aortic valve area, higher rate of moderate-severe calcification, lower mean trans-aortic valve gradient and lower left ventricular ejection fraction. In large-annuli SEVs were associated with a lower VARC-2 device success (75.9% vs. 90.6%, P = 0.049) driven by a higher rate of paravalvular valvular leak (PVL) compared to BEVs (20.7% vs. 1.2%, P &amp;lt; 0.001). However, no differences in clinical outcomes were observed according to annular size nor THV type. Conclusions TAVR in BAV patients is feasible irrespective of annular size. However in patients with large aortic annulus SEVs were associated with a significantly higher rate of PVLs compared to BEVs.

732 TEE role in patients selection for transcatheter edge to edge tricuspid repair

Abstract Aims The natural history of tricuspid valve (TV) regurgitation is characterized by dismal prognosis and high in-hospital mortality when treated with isolated TV surgery. Although the anatomy and the imaging of the TV are very challenging, the edge-to-edge repair with the TriClip (Abbott Vascular, Santa Clara, CA) showed promising results. We report preliminary results of our experience with the TriClip System in a cohort of ‘real life’ patients with functional tricuspid regurgitation (TR). Methods and results From January to September 2021, 30 consecutive patients with severe TR has been screened, 8 underwent transcatheter TriClip repair. The anatomical feasibility was established according to a complete transesophageal echocardiogram (TEE) and a dedicated CT scan for the right cardiac chambers. All the echocardiographic projections focused on right ventricle were used during the procedure, with the aim of optimizing the visualization of the catheters and device with respect to the anatomical structures of the tricuspid valve complex. The procedure was conducted under general anesthesia, guided by TEE and fluoroscopy. In-hospital and 30-day clinical and echocardiographic outcomes were recorded. The annulus septo-lateral diameter was enlarged in all cases, and functional TR was present in all patients. In two patients, the pacemaker lead interfered with leaflets coaptation. TR jet was predominantly central. The implant and procedural success were achieved in all cases, implanting one device in five patients and two in three patients. The final TR grade was 2+ in four patients and and 1+ in the others. All patients were extubated in the catheterization laboratory. There were no procedural or in-hospital adverse events. At 30-day follow-up, we observed significant improvement in clinical and echocardiographic outcomes. Conclusions In our experience, 26% of screened patients were selected for the procedure. Favourable anatomical findings for the TV edge-to-edge repair were the following: moderate leaflet tethering (coaptation depth &amp;lt;10 mm); large annulus but with small coaptation gap (&amp;lt;7 mm); antero-septal or postero-septal jet location; commissural jet; small right ventricular dimensions; pacemaker lead with no leaflet tethering. The best transcatheter approach consists of obliterating the antero-septal coaptation rim for a more favourable angle between the inferior vena cava and valvular plane. High-quality TEE imaging during the procedure is required for obtaining procedural success. Patient selection and tricuspid valve anatomy characterization with TEE and cardiac CT scan is critical for procedural success and clinical improvements.

Annular size and interaction with trans-catheter aortic valves for treatment of severe bicuspid aortic valve stenosis: Insights from the BEAT registry

BackgroundTranscatheter aortic valve replacement (TAVR) is safe and feasible in patients with bicuspid aortic valve (BAV), but whether annular size may influence TAVR results in BAV patients remains unclear. We aimed at evaluating the impact of aortic annular size on procedural and clinical outcomes of BAV patients undergoing TAVR, as well as potential interactions between annular dimension and trans-catheter heart valve (THV) type (balloon-expandable (BEV) vs. self-expanding (SEV). MethodsBEAT is a multicenter registry of consecutive BAV stenosis undergoing TAVR. For this sub-study patients were classified according to annular dimension in small-annulus (area < 400 mm2 or perimeter <72 mm), medium-annulus (area ≥ 400 and < 575 mm2, perimeter ≥72 mm and< 85 mm), large-annulus (area ≥ 575 mm2 or perimeter ≥85 mm). Primary endpoint was Valve Academic Research Consortium-2 (VARC-2) device success. Results45(15.5%) patients had small, 132(45.3%) medium, and 114(39.2%) large annuli. Compared with other groups, patients with large annuli were more frequently male, younger, with higher body mass index, larger aortic valve area, higher rate of moderate-severe calcification, lower mean trans-aortic valve gradient and lower left ventricular ejection fraction. In large-annuli SEVs were associated with a lower VARC-2 device success (75.9% vs. 90.6%, p = 0.049) driven by a higher rate of paravalvular valvular leak (PVL) compared to BEVs (20.7% vs. 1.2%, p < 0.001). However, no differences in clinical outcomes were observed according to annular size nor THV type. ConclusionsTAVR in BAV patients is feasible irrespective of annular size. However in patients with large aortic annulus SEVs were associated with a significantly higher rate of PVLs compared to BEVs.

Transcatheter Aortic Valve Replacement for Pure Aortic Regurgitation in a Largeand Noncalcified Annulus.

Transcatheter Aortic Valve Replacement for Pure Aortic Regurgitation in a Largeand Noncalcified Annulus.

Directional maximal function along the primes

We study a two-dimensional discrete directional maximal operator along the set of the prime numbers. We show existence of a set of vectors, which are lattice points in a sufficiently large annulus, for which the $\ell^2$ norm of the associated maximal operator, with supremum taken over all large scales, grows with an epsilon power in the number of vectors. This paper is a follow-up to a prior work on the discrete directional maximal operator along the integers by the first and third author.

Drift-Flux Parameters for High-Viscous-Oil/Gas Two-Phase Upward Flow in a Large and Narrow Vertical and Inclined Annular Duct

Abstract Proper sizing of flow lines in the upstream energy industry depends on accurate modeling of gas–liquid flow, which has a common occurrence in production wells and has been studied thoroughly for many decades. However, data of flow in duct geometries different from circular pipes and when the liquid viscosity is much higher than that of water are scarce. Proper prediction of pressure gradient, heat and mass transfer, and corrosion depends on the accuracy of the model used to calculate the volumetric phase fraction. In pumped directional wells with inverted-shroud gravitational separators, there is flow through an annular duct formed between the wells’ casing and the separator itself that can have some tens of meters. The present work is an investigation on upward vertical/inclined high-viscous-oil/gas flow in a large and narrow annulus (30 mm hydraulic diameter with an outer diameter equal to 155 mm), using a radial geometry comparable with those found in real production systems. Air–water and air–oil mixtures, the latter with two oil viscosity ranges, were used as working fluids. The experimental test section used was 9.67 m long positioned at 90 deg (vertical) and 45 deg and made of two concentric pipes. Flow pattern transitions from the literature were analyzed and compared with the collected experimental data. Drift-flux parameters were obtained from multiple working conditions. These drift-flux parameters were used in the development of a novel flow pattern-independent correlation, compared against the present data and other data sets from the literature in which other geometries and fluids were used. The predictions of the proposed drift-flux correlation are significantly superior in comparison with correlations selected from the literature in all cases.

Transcatheter Aortic Valve Implantation in Bicuspid Aortic Valve Pathology: Current Evidence and Technical Challenges

Transcatheter aortic valve implantation (TAVI) is an established therapy for severe symptomatic aortic valve stenosis (AS) in patients at high and intermediate risk for surgical aortic valve replacement (SAVR). Current evidence also suggests at least non-inferiority of TAVI in low-risk patients compared to SAVR. However, there are special subsets of patients and anatomical circumstances in which TAVI is traditionally considered a suboptimal treatment strategy due to procedure inherent increased risks (e.g., rupture of cardiac chambers in patients with severe calcifications of the left ventricular outflow tract, valve migration in very large aortic annuli). One of these special subsets is bicuspid AS. Bicuspid aortic valve disease is the most common congenital heart defect and most frequent reason for AS in patients &lt;70 years of age. Bicuspid aortic valve pathology is characterized by special anatomical complexities like asymmetrical cusp proportion and calcium distribution, a more pronounced annular ellipticity compared to tricuspid aortic valves and concomitant dilation of the thoracic aorta. These factors have led physicians to traditionally indicate TAVI more reluctantly in those patients in the past. In this article, current evidence for TAVI for bicuspid AS is discussed and technical challenges are highlighted.

Laser Assisted Dirac Electron in a Magnetized Annulus

We study the behaviour of a charge bound on a graphene annulus under the assumption that the particle can be treated as a massless Dirac electron. The eigenstates and relative energy are found in closed analytical form. Subsequently, we consider a large annulus with radius ρ∈[5000,10,000]a0 in the presence of a static magnetic field orthogonal to its plane and again the eigenstates and eigenenergies of the Dirac electron are found in both analytical and numerical form. The possibility of designing filiform currents by controlling the orbital angular momentum and the magnetic field is shown. The currents can be of interest in optoelectronic devices that are controlled by electromagnetic radiation. Moreover, a small radial force acts upon the annulus with a stretching effect. A linearly polarized electromagnetic field propagating in the orthogonal direction is added; the time evolution of the operators show that the acceleration of the electron is proportional to the rate of change of the spin of the particle.

A new technique that prevents paravalvular leakage after aortic valve replacement using a rapid-deployment valve system.

We report our 1-year single-center experience of a new technique of aortic valve replacement using a rapid-deployment valve (RD-AVR) to avoid postoperative complications. We also report the unexpected pitfalls and handling techniques that we have seen in past cases. We performed aortic valve replacement on 38 patients between May 2019 and April 2020. Their mean age was 74 years. The primary outcomes were in-hospital mortality and short-term results during a 1-year follow-up period, while the secondary outcomes were related to prosthetic valve function, especially paravalvular leakage (PVL). We further analyzed the relationship between the new technique and its outcomes. The mean operative time was 196 min. There were no in-hospital deaths, and the mean duration of postoperative hospital stay was 11.8 days. Valvular measurements using three-dimensional computed tomography were larger and more accurate than those measured using ultrasonic echocardiography. Postoperative RD-AVR prosthetic valve function was excellent. However, PVL occurred in four cases 1 week and 1 year postoperatively and regurgitation did not improve. A gap associated with PVL was identified below the right-noncoronary commissure. To prevent PVL, we additionally stitched this gap in the later 18 cases; there was no case of PVL and no new pacemaker implantation in these cases. PVL is more likely to occur if there is a gap below the R-N commissure, especially in cases with a large annulus; therefore, applying an additional stitch to the R-N commissure is extremely useful.

Singular orbits and Baker domains

We show that there is a transcendental meromorphic function with an invariant Baker domain U such that every singular value of f is a super-attracting periodic point. This answers a question of Bergweiler from 1993. We also show that U can be chosen to contain arbitrarily large round annuli, centred at zero, of definite modulus. This answers a question of Mihaljević and the author from 2013, and complements recent work of Barański et al concerning this question.

Replacement of the Mitral Valve Under One Year of Age: Size Matters.

Surgical management of mitral valve disease in neonates and infants is challenging. When repair is no longer feasible, replacement may become inevitable, but should only be considered as an option of last resort due to the remarkably high rate of associated morbidity and mortality. Mechanical valves are the preferred choice in large annuli, while stented conduits seem promising in smaller ones. In patients with a preoperative mitral valve annulus equal or larger than 15-16 mm, an intra-annular placement of the smallest mechanical valve available should be attempted. In patients with smaller annuli, the placement of a stented valved conduit seems to display a lower mortality risk. Supra-annular implantation of prostheses should be reserved for exceptional cases and to those familiar with this technique because of the high rate of associated complications.

Feasibility of Transcatheter Aortic Valve Replacement in Prior Aortic Root Surgery

Aortic root replacement (ARR) introduces several anatomic complexities relevant to valve-in-valve (VIV)-transcatheter aortic valve replacement (TAVR) that may (1) increase the risk of coronary obstruction, (2) necessitate transcatheter valve overexpansion to accommodate large annuli, and (3) require alternative vascular access to navigate aortic kinking. Therefore, we aimed to quantify the feasibility of VIV-TAVR in patients who underwent aortic root surgery. Postoperative computed tomography scans were reviewed for consecutive patients who underwent ARR between 2005 and 2019 to obtain measurements relevant for VIV-TAVR planning. Virtual transcatheter valve to coronary ostia distance was measured to assess the risk of coronary obstruction. Root morphologies were classified into 1 of 4 groups based on aortic graft type, aortic diameter at the sinotubular junction, sinus height, estimated transcatheter heart valve height, and diameter. VIV-TAVR was projected to be complex in patients with an aortic kink, extremely large annulus, or heightened risk of coronary obstruction. Among 848 patients who underwent ARR during the 15-year study period, qualifying contrast-enhanced scans post-ARR were performed in 81 patients. Complex VIV-TAVR was anticipated in 50.6% of subjects. Patients with abnormal root anatomy experienced increased odds of complex VIV-TAVR relative to patients with normal root physiology (ie, sinotubular junction diameter>transcatheter heart valve diameter, sinus height>transcatheter heart valve height) or those who received straight tube grafts (odds ratio, 4.53 [95% CI, 1.02-20.1], P=0.046). The odds of complex VIV-TAVR were also higher among patients who underwent aortic valve replacement-ARR with a stentless bioprosthesis (stentless versus stented, odds ratio, 4.63 [95% CI, 1.40-15.3], P=0.012; stentless versus valve-sparing ARR, odds ratio, 3.78 [95% CI, 1.14-12.5], P=0.029). ARR patients with atypical root morphologies or those who underwent valve replacement with stentless bioprostheses may be at high risk for complex VIV-TAVR. Prospective evaluation is required to assess the impact of these conclusions on procedural feasibility.

Geometrical predictors of small virtual neoLVOT size in functional mitral regurgitation

Abstract Background LVOT obstruction is a potentially lethal complication of transcatheter mitral valve replacement (TMVR). An anticipated neoLVOT area of &amp;lt;2cm2 is presumed to imply prohibitive risk. Measurement of the anticipated neoLVOT can be time consuming and requires specialist software to facilitate virtual valve implantation. Purpose To determine simple geometrical predictors of prohibitive neoLVOT size. Methods 165 consecutive, non-calcific FMR patients referred to a transcatheter heart valve program were analysed. Segmentation of the mitral annulus and left heart geometry was performed using CT. Suitability for a default D-shaped TMVR was determined by proprietary annular inclusion criteria. Systolic neoLVOT area was determined via virtual valve implantation of the default TMVR. Results Sufficient image data for annular and neoLVOT suitability assessment was available in 152 patients. 105 patients (69%) were suitable for TMVR based on annular measurements. Of these, neoLVOT area was &amp;gt;2cm2 in 88 (84%). Overall, compared to patients not suitable for TMVR (n=64), those suitable had larger ventricles with lower LVEF, and larger annuli (table 1). Using binomial logistic regression involving the variables within table 1, LVESD was the sole statistically significant variable to predict neoLVOT area of &amp;lt;2cm2 (p=0.02). LVESD &amp;lt;48mm had 82% sensitivity and 94% specificity for the presence of prohibitive neoLVOT (figure 1). Conclusion Smaller LVESD is a strong predictor of small neoLVOT, and hence LVOT obstruction post default D-shaped TMVR implantation. This simple measure may therefore be used to streamline patient selection for advanced pre-procedural imaging analysis. Predicting NeoLVOT size &amp;lt;2 cm2 Funding Acknowledgement Type of funding source: None