Key result
Uniform 35 mm outlet tubes violate ISO standards and underestimate effective orifice diameter in smaller valves.
Questions accuracy of EOA data for smaller valves; leaves open whether size-specific testing alters clinical selection or outcomes.
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Boxtel et al. (2026) conducted a letter in Prosthetic heart valves. Using a uniform 35 mm outlet tube for all prosthetic valve sizes violates ISO guidelines and underestimates the effective orifice diameter in smaller valves.
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