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Tobe A, Onuma Y, Soliman O, Baumbach A, Serruys PW. Glimpse Into the Hemodynamic Performance of Myval Series vs Sapien 3 Ultra Resilia. STRUCTURAL HEART : THE JOURNAL OF THE HEART TEAM 2025; 9:100394. [PMID: 40321307 PMCID: PMC12047505 DOI: 10.1016/j.shj.2024.100394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/15/2024] [Revised: 11/26/2024] [Accepted: 12/04/2024] [Indexed: 05/08/2025]
Abstract
•The Myval series are novel balloon-expandable transcatheter heart valves.•The postprocedural effective orifice area and mean pressure gradient of the Myval series were compared with those of the Sapien 3 Ultra Resilia using published data.•The Myval series seems to have effective orifice areas and mean pressure gradients comparable to those of Sapien 3 Ultra Resilia.
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Affiliation(s)
- Akihiro Tobe
- Department of Cardiology, School of Medicine, University of Galway, Galway, Ireland
- CORRIB Research Center for Advanced Imaging and Core Laboratory, Galway, Ireland
| | - Yoshinobu Onuma
- Department of Cardiology, School of Medicine, University of Galway, Galway, Ireland
- CORRIB Research Center for Advanced Imaging and Core Laboratory, Galway, Ireland
| | - Osama Soliman
- Department of Cardiology, School of Medicine, University of Galway, Galway, Ireland
- CORRIB Research Center for Advanced Imaging and Core Laboratory, Galway, Ireland
| | - Andreas Baumbach
- Centre for Cardiovascular Medicine and Devices, William Harvey Research Institute, Queen Mary University of London and Barts Heart Centre, London, UK
- Cleveland Clinic London, London, UK
| | - Patrick W. Serruys
- Department of Cardiology, School of Medicine, University of Galway, Galway, Ireland
- CORRIB Research Center for Advanced Imaging and Core Laboratory, Galway, Ireland
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Kini AS, Tang GHL, Yaryura R, Petrossian G, Roberts DK, Rahman A, Saltzman A, Durkin R, DeVries JT, Stinis C. 1-Year Real-World Outcomes of TAVR With the Fifth-Generation Balloon-Expandable Valve in the United States. JACC Cardiovasc Interv 2025; 18:785-797. [PMID: 39665706 DOI: 10.1016/j.jcin.2024.11.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2024] [Revised: 11/14/2024] [Accepted: 11/14/2024] [Indexed: 12/13/2024]
Abstract
BACKGROUND Longer term outcomes of transcatheter aortic valve replacement (TAVR) with the SAPIEN 3 Ultra RESILIA (S3UR) valve over its predecessors have not been reported in a national registry. OBJECTIVES The aim of this study was to compare the 1-year clinical and echocardiographic outcomes of the S3UR with those of the SAPIEN 3 (S3) and SAPIEN 3 Ultra (S3U) in the Society of Thoracic Surgeons/American College of Cardiology TVT (Transcatheter Valve Therapy) Registry. METHODS From September 2022 to March 2023, patients who underwent native TAVR with the S3UR or the S3 or S3U valve were propensity matched and compared. Predictors of 1-year outcomes were identified. The median follow-up time was 358 days (Q1-Q3: 47-365 days) for the S3UR and 364 days (Q1-Q3: 80-365 days) for the S3 and S3U. RESULTS A total of 4,598 S3UR patients were propensity matched with 4,598 and 32,536 S3 and S3U patients. At discharge, effective orifice areas were larger in the S3UR group (P < 0.0001). The lower discharge mean gradient in the S3UR group was maintained at 30 days and 1 year (P < 0.0001 for all). At 1 year, all-cause mortality (7.6% vs 9.7%; HR: 0.8; 95% CI: 0.67-0.93; P = 0.004), mild or greater paravalvular leak (PVL) (15.6% vs 18.5%; HR: 0.82; 95% CI: 0.69-0.97; P = 0.02), and life-threatening bleeding (2.0% vs 2.7%; HR: 0.7; 95% CI: 0.54-0.94; P = 0.03) were lower in the S3UR group. S3UR and mild or greater PVL were predictive of 1-year mortality in the overall cohort and in low-risk patients. Valve reintervention remained rare at 1 year (0.6% vs 0.4%; HR: 1.46; 95% CI: 0.77-2.78; P = 0.25). CONCLUSIONS TAVR with the S3UR is associated with superior 1-year clinical outcomes and lower gradients than its predecessors, with less PVL and low valve reintervention. Longer follow-up will determine the durability of the RESILIA technology in the SAPIEN valve platform.
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Affiliation(s)
- Annapoorna S Kini
- Mount Sinai Fuster Heart Hospital, Mount Sinai Health System, New York, New York, USA.
| | - Gilbert H L Tang
- Mount Sinai Fuster Heart Hospital, Mount Sinai Health System, New York, New York, USA.
| | | | | | | | - Ayaz Rahman
- Cardiology Associates of East Tennessee, Knoxville, Tennessee, USA
| | - Adam Saltzman
- Southcoast Physicians Group, Fall River, Massachusetts, USA
| | - Raymond Durkin
- Department of Cardiology, St. Luke's University Hospital, Bethlehem, Pennsylvania, USA
| | - James T DeVries
- Division of Cardiology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
| | - Curtiss Stinis
- Division of Cardiology, Scripps Clinic, La Jolla, California, USA
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Avvedimento M, Giuliani C, Zanuttini A, Mengi S, Mas-Peiro S, Poulin A, Beaupré F, Paradis JM, Porterie J, Kalavrouziotis D, Dumont E, Mohammadi S, Côté M, Pibarot P, Rodés-Cabau J. Hemodynamic Performance of the SAPIEN 3 Ultra Resilia Valve: Insights From a Propensity-Matched Analysis. J Am Soc Echocardiogr 2025; 38:132-135. [PMID: 39490455 DOI: 10.1016/j.echo.2024.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2024] [Revised: 10/14/2024] [Accepted: 10/15/2024] [Indexed: 11/05/2024]
Affiliation(s)
- Marisa Avvedimento
- Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada
| | - Carlos Giuliani
- Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada
| | - Antonela Zanuttini
- Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada
| | - Siddhartha Mengi
- Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada
| | - Silvia Mas-Peiro
- Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada
| | - Anthony Poulin
- Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada
| | - Frederic Beaupré
- Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada
| | - Jean-Michel Paradis
- Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada
| | - Jean Porterie
- Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada
| | | | - Eric Dumont
- Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada
| | - Siamak Mohammadi
- Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada
| | - Mélanie Côté
- Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada
| | - Philippe Pibarot
- Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada
| | - Josep Rodés-Cabau
- Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada; Clinic Barcelona, Barcelona, Spain
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Leone PP, Sturla M, Spring AM, Echarte-Morales J, Scotti A, Ludwig S, Coisne A, Slipczuk L, Assafin M, Chau M, Ho EC, Granada JF, Latib A. Routine postdilation after 23 mm Sapien 3 Ultra implantation in the aortic position. Catheter Cardiovasc Interv 2024; 104:559-569. [PMID: 38841916 DOI: 10.1002/ccd.31116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 04/14/2024] [Accepted: 05/26/2024] [Indexed: 06/07/2024]
Abstract
BACKGROUND Residual transprosthetic gradient (TG) after transcatheter aortic valve replacement (TAVR) with balloon-expandable valves (BEV) may be due to suboptimal valve expansion. AIMS To compare hemodynamics after TAVR with small BEV according to postdilation strategy. METHODS This observational, retrospective cohort study included 184 consecutive patients from a single center treated with 23 mm Sapien 3 Ultra (Edwards Lifesciences) BEV implantation in the aortic position and enrolled between January 2020 and April 2023. Patients treated with routine postdilation (RP, n = 73) were compared to patients treated according to local standard practice (SP, n = 111). Primary endpoint was 30-day mean TG. Secondary endpoints were incidence of 30-day prosthesis-patient mismatch (PPM), technical success and device success. RESULTS Thirty-day mean TG was lower in RP versus SP (12.3 ± 4.6 mmHg vs. 14.1 ± 5.7 mmHg, p = 0.031), and incidence of PPM was less common with RP versus SP (47.3% vs. 71.0%, p = 0.006). Technical success (98.6% vs. 99.1%, p = 0.637) and device success (93.1% vs. 90.1%, p = 0.330) did not differ between groups. Differences in 30-day mean TG were driven by patients at normal flow (12.1 ± 4.0 mmHg vs. 15.0 ± 5.5 mmHg, p = 0.014), while no differences were evident among patients at low flow (12.5 ± 5.5 mmHg vs. 11.7 ± 5.5 mmHg, p = 0.644). RP decreased height and increased width of BEV, and a linear regression established that final BEV width could predict 30-day mean TG (r = -0.6654, p < 0.0001). CONCLUSIONS RP after TAVR with small BEV was associated with more favorable forward-flow hemodynamics than SP.
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Affiliation(s)
- Pier Pasquale Leone
- Division of Cardiology, Montefiore Medical Center, Bronx, New York, USA
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele-Milan, Italy
- Cardio Center, IRCCS Humanitas Research Hospital, Rozzano-Milan, Italy
| | - Matteo Sturla
- Division of Cardiology, Montefiore Medical Center, Bronx, New York, USA
| | | | | | - Andrea Scotti
- Division of Cardiology, Montefiore Medical Center, Bronx, New York, USA
- Cardiovascular Research Foundation, New York, USA
| | - Sebastian Ludwig
- Cardiovascular Research Foundation, New York, USA
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Luebeck, Hamburg, Germany
| | - Augustin Coisne
- Division of Cardiology, Montefiore Medical Center, Bronx, New York, USA
- Cardiovascular Research Foundation, New York, USA
- Inserm, CHU Lille, Institut Pasteur de Lille, University of Lille, Lille, France
| | - Leandro Slipczuk
- Division of Cardiology, Montefiore Medical Center, Bronx, New York, USA
| | - Manaf Assafin
- Division of Cardiology, Montefiore Medical Center, Bronx, New York, USA
| | - Mei Chau
- Division of Cardiology, Montefiore Medical Center, Bronx, New York, USA
| | - Edwin C Ho
- Division of Cardiology, Montefiore Medical Center, Bronx, New York, USA
| | - Juan F Granada
- Division of Cardiology, Montefiore Medical Center, Bronx, New York, USA
- Cardiovascular Research Foundation, New York, USA
| | - Azeem Latib
- Division of Cardiology, Montefiore Medical Center, Bronx, New York, USA
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Mitsuoka N, Takaseya T, Sasaki KI, Takagi K, Itaya N, Oshita K, Sasaki M, Yokomizo M, Nohara Y, Kuroki H, Fukumoto Y, Tayama E. Delayed migration of a Sapien 3 Ultra Resilia following transcatheter aortic valve implantation after selection of a smaller-sized valve. Oxf Med Case Reports 2024; 2024:omae065. [PMID: 38989505 PMCID: PMC11232457 DOI: 10.1093/omcr/omae065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 04/02/2024] [Accepted: 05/13/2024] [Indexed: 07/12/2024] Open
Abstract
This report discusses a rare case of delayed migration of a Sapien 3 Ultra Resilia (S3UR) valve following transcatheter aortic valve implantation. An 81-year-old Japanese woman had a borderline aortic annular size of 20-23 mm according to the manufacturer's size chart. We chose to implant a smaller S3UR of 20 mm with an 80/20 depth ratio to allow for a second intervention, ensuring good hemodynamics and minimizing paravalvular leak. The patient initially had a favorable outcome despite an accidental 50/50 depth ratio during implantation. On postoperative day 3, the S3UR migrated into the left ventricular outflow tract. Emergency surgical aortic valve replacement was performed to retrieve the migrated valve. Use of the S3UR has led to a growing preference for smaller valve sizes. However, the risk of migration should be recognized. When an accidental 50/50 depth ratio implantation is encountered, post-dilation or second valve implantation should be performed immediately.
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Affiliation(s)
- Nagiko Mitsuoka
- Division of Cardiovascular Surgery, Department of Surgery, Kurume University School of Medicine, Asahi-machi 67, Kurume-si, Fukuoka 830-0011, Japan
| | - Tohru Takaseya
- Division of Cardiovascular Surgery, Department of Surgery, Kurume University School of Medicine, Asahi-machi 67, Kurume-si, Fukuoka 830-0011, Japan
| | - Ken-ichiro Sasaki
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Asahi-machi 67, Kurume-si, Fukuoka 830-0011, Japan
| | - Kazuyoshi Takagi
- Division of Cardiovascular Surgery, Department of Surgery, Kurume University School of Medicine, Asahi-machi 67, Kurume-si, Fukuoka 830-0011, Japan
| | - Naoki Itaya
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Asahi-machi 67, Kurume-si, Fukuoka 830-0011, Japan
| | - Kensuke Oshita
- Department of Anesthesiology, Kurume University School of Medicine, Asahi-machi 67, Kurume-si, Fukuoka 830-0011, Japan
| | - Masahiro Sasaki
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Asahi-machi 67, Kurume-si, Fukuoka 830-0011, Japan
| | - Michiko Yokomizo
- Department of Anesthesiology, Kurume University School of Medicine, Asahi-machi 67, Kurume-si, Fukuoka 830-0011, Japan
| | - Yume Nohara
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Asahi-machi 67, Kurume-si, Fukuoka 830-0011, Japan
| | - Hidefumi Kuroki
- Division of Radiology, Kurume University Hospital, Asahi-machi 67, Kurume-si, Fukuoka 830-0011, Japan
| | - Yoshihiro Fukumoto
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Asahi-machi 67, Kurume-si, Fukuoka 830-0011, Japan
| | - Eiki Tayama
- Division of Cardiovascular Surgery, Department of Surgery, Kurume University School of Medicine, Asahi-machi 67, Kurume-si, Fukuoka 830-0011, Japan
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Stinis CT, Abbas AE, Teirstein P, Makkar RR, Chung CJ, Iyer V, Généreux P, Kipperman RM, Harrison JK, Hughes GC, Lyons JM, Rahman A, Kakouros N, Walker J, Roberts DK, Huang PH, Kar B, Dhoble A, Logsdon DP, Khanna PK, Aragon J, McCabe JM. Real-World Outcomes for the Fifth-Generation Balloon Expandable Transcatheter Heart Valve in the United States. JACC Cardiovasc Interv 2024; 17:1032-1044. [PMID: 38456883 DOI: 10.1016/j.jcin.2024.02.015] [Citation(s) in RCA: 21] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 02/14/2024] [Accepted: 02/14/2024] [Indexed: 03/09/2024]
Abstract
BACKGROUND The fifth-generation SAPIEN 3 Ultra Resilia valve (S3UR) incorporates several design changes as compared with its predecessors, the SAPIEN 3 (S3) and SAPIEN 3 Ultra (S3U) valves, including bovine leaflets treated with a novel process intended to reduce structural valve deterioration via calcification, as well as a taller external skirt on the 29-mm valve size to reduce paravalvular leak (PVL). The clinical performance of S3UR compared with S3 and S3U in a large patient population has not been previously reported. OBJECTIVES The aim of this study was to compare S3UR to S3/S3U for procedural, in-hospital, and 30-day clinical and echocardiographic outcomes after transcatheter aortic valve replacement (TAVR). METHODS Patients enrolled in the STS/ACC TVT (Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy) Registry between January 1, 2021, and June 30, 2023, who underwent TAVR with S3UR or S3U/S3 valve platforms were propensity-matched and evaluated for procedural, in-hospital, and 30-day clinical and echocardiographic outcomes. RESULTS 10,314 S3UR patients were propensity matched with 10,314 patients among 150,539 S3U/S3 patients. At 30 days, there were no statistically significant differences in death, stroke, or bleeding, but a numerically higher hospital readmission rate in the S3UR cohort (8.5% vs 7.7%; P = 0.04). At discharge, S3UR patients exhibited significantly lower mean gradients (9.2 ± 4.6 mm Hg vs 12.0 ± 5.7 mm Hg; P < 0.0001) and larger aortic valve area (2.1 ± 0.7 cm2 vs 1.9 ± 0.6 cm2; P < 0.0001) than patients treated with S3/S3U. The 29-mm valve size exhibited significant reduction in mild PVL (5.3% vs 9.4%; P < 0.0001). CONCLUSIONS S3UR TAVR is associated with lower mean gradients and lower rates of PVL than earlier generations of balloon expandable transcatheter heart valve platforms.
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Affiliation(s)
- Curtiss T Stinis
- Division of Cardiology, Scripps Clinic, La Jolla, California, USA.
| | - Amr E Abbas
- Corewell Health East, William Beaumont University Hospital, Royal Oak, Michigan, USA
| | - Paul Teirstein
- Division of Cardiology, Scripps Clinic, La Jolla, California, USA
| | - Raj R Makkar
- Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Christine J Chung
- University of Washington Medical Center, Department of Medicine, Division of Cardiology, Seattle, Washington, USA
| | - Vijay Iyer
- Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, New York, USA
| | - Philippe Généreux
- Gagnon Cardiovascular Institute at Morristown Medical Center, Morristown, New Jersey, USA
| | - Robert M Kipperman
- Atlantic Health System Morristown Medical Center, Morristown, New Jersey, USA
| | - John K Harrison
- Division of Cardiology, Department of Medicine, Duke University Hospital, Durham, North Carolina, USA
| | - G Chad Hughes
- Division of Cardiology, Department of Medicine, Duke University Hospital, Durham, North Carolina, USA
| | | | - Ayaz Rahman
- Cardiology Associates of East Tennessee, Knoxville, Tennessee, USA
| | - Nikolaos Kakouros
- Division of Cardiology, University of Massachusetts School of Medicine, Worcester, MA, USA
| | - Jennifer Walker
- Department of Medicine, Division of Cardiology, University of North Carolina at Chapel Hill, North Carolina, USA
| | | | | | - Biswajit Kar
- Division of Cardiology, Department of Internal Medicine, University of Texas Health Science Center, Houston, Texas, USA
| | - Abhijeet Dhoble
- Division of Cardiology, Department of Internal Medicine, University of Texas Health Science Center, Houston, Texas, USA
| | | | | | - Joseph Aragon
- Santa Barbara Cottage Hospital, Santa Barbara, California, USA
| | - James M McCabe
- Division of Cardiology, University of Washington Medical Center, Seattle, Washington, USA
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Vinayak M, Leone PP, Tanner R, Dhulipala V, Camaj A, Makhija RRK, Hooda A, Kini AS, Sharma SK, Khera S. Transcatheter Aortic Valve Replacement: Current Status and Future Indications. J Clin Med 2024; 13:373. [PMID: 38256506 PMCID: PMC10817053 DOI: 10.3390/jcm13020373] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 12/31/2023] [Accepted: 01/04/2024] [Indexed: 01/24/2024] Open
Abstract
In the past two decades, transcatheter aortic valve replacement (TAVR) has transformed the management of aortic stenosis and has become the standard of care regardless of surgical risk levels. Advances in transcatheter valve design across newer generations, improved imaging, greater operator expertise, and technical enhancements have collectively contributed to increased safety and a decline in procedural complications over this timeframe. The application of TAVR has progressively expanded to include younger patients with lower risks, who have longer life expectancies. This article offers an up-to-date review of the latest innovations in transcatheter delivery systems, devices, and its possible future indications.
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Affiliation(s)
- Manish Vinayak
- Mount Sinai Heart, Mount Sinai Hospital, New York, NY 10029, USA; (P.P.L.); (R.T.); (V.D.); (A.C.); (R.R.K.M.); (A.H.); (A.S.K.); (S.K.S.)
| | | | | | | | | | | | | | | | | | - Sahil Khera
- Mount Sinai Heart, Mount Sinai Hospital, New York, NY 10029, USA; (P.P.L.); (R.T.); (V.D.); (A.C.); (R.R.K.M.); (A.H.); (A.S.K.); (S.K.S.)
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