was 77.49.4 years, 92 (76%) were man, median NYHA class was 3.0 (IQR 3.0-3.0), mean LVEF was 50.613.9% and mean aortic gradient was 40.814.8 mmHg. Trans-femoral access was used in 86 (71.1%) patients, a trans-apical in 31 (25.6%), a subclavian in 3 (2.5%) and a trans-aortic in 1 (0.8%). Mean mitro-aortic distance at CT was 8.34.1 mm. An aortic balloon-expandable valve was used in 74 (61%) cases. Mean size of employed aortic prostheses was 26.33.2 mm, a mean of 160.18.1 ml of iodine contrast was used, and procedures took a mean of 97.058.2 min. Procedural success was achieved in 114 (94%) patients, with effective reduction of mean aortic gradients (10.17.8 vs 40.814.8 mmHg; p<0.001). Balloon predilatation was performed in 52 (43%) patients. No cases of post-procedural severe aortic regurgitation or device embolization were observed. Balloon post-dilatation was needed in 18 (15%) patients. One case of surgery conversion was needed. 4 patients needed a second valve implanted. No cases of mitral prosthesis malfunctioning due to TAVR were re- ported. We observed 7 (5%) cases of in-hospital death. Median hos- pital stay length was 9 (range 1-65) days. 7 (5%) patients needed a new permanent pacemaker implantation. 3 (2.5%) periprocedural strokes, 10 (8%) major vascular complications, 10 (8%) major bleedings and 1 (0.8%) case of periprocedural myocardial infarction occurred. No differences in outcomes were found between patients with mitral mechanical or biological prostheses. At a median follow-up of 20.412.5 months, 21 (17.5%) deaths occurred. Of these, 11 (9.2%) were cardiac-related (mostly due to advanced heart failure). However, 1 was related to mitral prosthesis dysfunction and 1 to mitral prosthesis thrombosis. No cases of stroke or myocardial infarction and no cases requiring repeat cardiac surgery were recorded. 17 (14.2%) patients were subsequently hospitalized due to heart failure. Overall, at follow-up, a significant NYHA class reduction to 2.0 (IQR 2-3) vs 3.0 (IQR 3.0-3.0); p<0.001 was noted and mean aortic gradients remained significantly lower (8.94.6 vs 42.915.1 mmHg; p<0.001) than baseline. CONCLUSION To our knowledge this is the largest case-series reporting on TAVR procedural and clinical outcomes in the setting of PMP. Our preliminary analyses show how the procedure is feasible and safe, with low rates of complications. Benefits of TAVR inter- vention were maintained at follow-up, even in this potentially higher risk subgroup of patients. CATEGORIES STRUCTURAL: Valvular Disease: Aortic INTRAVASCULAR IMAGING AND PCI Abstract nos: 41 - 44 TCT-41 Initial Pre-clinical Porcine and Ex-Vivo Human Coronary Images with a Hybrid Intravascular Ultrasound and Optical Coherence Tomography System Brian Courtney, 1 Brian Li, 2 Natasha Alves-Kotzev, 2 Mark Harduar, 3 M. Saleem, 3 Jill Weyers, 2 Angela Kim, 2 Amandeep Thind, 4 Jagdish Butany 5 1 Sunnybrook Research Institute and Conavi Medical Inc., Toronto, Ontario, Canada; 2 Sunnybrook Research Institute, Toronto, Ontario, Canada; 3 Conavi Medical Inc., Toronto, Ontario, Canada; 4 Conavi Medical Inc, Toronto, Ontario, Canada; 5 University Health Network, Toronto, Ontario, Canada BACKGROUND Intravascular ultrasound (IVUS) and optical coherence tomography (OCT) are widely used to image coronary arteries, plaque and devices, but are currently only available on separate catheters and systems. Hybrid IVUS OCT may facilitate a practical approach to col- lecting the high resolution and high-contrast images of OCT along with the deeper penetration depth of IVUS. METHODS A 2.8F imaging system was developed that collects inher- ently co-registered 40 MHz IVUS and OCT images at up to 100 frames per second. Coronary arteries were harvested from formalin-fixed hearts at autopsy under an REB approved protocol and imaged via hybrid IVUS-OCT pullback. Histology was performed for comparison using H&E and Masson’s Trichrome staining. The system was also tested in vivo in porcine coronary arteries under an Animal Care Committee approved protocol. RESULTS Co-registered images of a range of pathologies were generated using IVUS, OCT and histology, including normal sections, deep and superficial calcifications, fibroatheromas with thin and thick caps, early-staged lesions and stent thrombosis. Pullback was per- formed in a porcine animal model, including the demonstration of stent malapposition. The left panel in the figure demonstrates an in vivo IVUS image of a stented artery, while the right panel is the cor- responding OCT image. Both images were acquired simultaneously at the same cross-section. CONCLUSION In vivo imaging of coronary anatomy using a hybrid IVUS OCT catheter and system is feasible. Upcoming clinical in- vestigations will assess the utility of this technology in assessing coronary anatomy, plaque characteristics and procedural results. CATEGORIES IMAGING: Imaging: Intravascular TCT-42 Long-term Consequences Of Optical Coherence Tomography Findings During Percutaneous Coronary Intervention: The Centro Per La Lotta Contro l’Infarto - Optimization Of Percutaneous Coronary Intervention (CLI-OPCI) LATE Study Enrico Romagnoli, 1 Alessio La Manna, 2 Francesco Burzotta, 3 Laura Gatto, 4 Valeria Marco, 5 Chiara Russo, 5 Alessandro Di Giorgio, 6 Alberto Boi, 7 Ugo Limbruno, 8 Massimo Fineschi, 9 Franco Fabbiocchi, 10 Nevio Taglieri, 11 Francesco Versaci, 12 Carlo Trani, 13 Corrado Tamburino, 14 Fernando Alfonso, 15 Gary Mintz, 16 Francesco Prati 4 1 San Giovanni Addolorata Hospital; C.L.I Foundation, Rome, Rome, Italy; 2 University of Catania, Catania, Catania, Italy; 3 Institute of Cardiology, Catholic University of the Sacred Heart, Policlinico A. Gemelli, Rome, Rome, Italy; 4 San Giovanni Addolorata Hospital; C.L.I. Foundation, Rome, Rome, Italy; 5 C.L.I. Foundation, Rome, Rome, Italy; 6 Policlinico G. Martino, Messina, Messina, Italy; 7 Ospedale Brotzu, Cagliari, Cagliari, Italy; 8 ASL 9 Grosseto Hospital, Grosseto, Grosseto, Italy; 9 Azienda Ospedaliera Universitaria Senese Siena, Siena, Siena, Italy; 10 Centro Cardiologico Monzino, IRCCS, Milan, Milan, Italy; 11 Policlinico Sant’Orsola-Malpighi, Bologna, Bologna, Italy; 12 Ospedale Santa Maria Goretti, Latina, Latina, Italy; 13 Institute of Cardiology, Catholic University of the Sacred Heart, Policlinico A. Gemelli, Italy, Rome, Rome, Italy; 14 Ferrarotto Hospital, Cardiology Division, University of Catania, Catania, Italy; 15 Hospital Universitario de la Princesa, Madrid, Spain; 16 Cardiovascular Research Foundation, New York, New York, United States BACKGROUND Optical coherence tomography (OCT)-defined subop- timal stent deployment is an independent predictor of device failure in the first year of follow-up; however, its impact on long-term outcome remains undefined. The aim of this study is to evaluate clinical consequences of OCT findings on long-term outcome of percutaneous coronary interventions (PCI). METHODS In the context of the multicenter Centro per la Lotta contro l’Infarto-Optimisation of Percutaneous Coronary Intervention (CLI- OPCI) project, we compared long-term clinical outcome of patients undergoing PCI according to end-procedural OCT findings. RESULTS To date the CLI-OPCI project enrolled 1422 lesions out of 1211 patients from 13 independent OCT-experienced centers. End- procedural OCT assessment revealed suboptimal stent implantation in 30.9% of lesions, with increased incidence in patients experiencing device-oriented cardiovascular events (DoCE) (52.8% vs. 28.0%, p<0.001). At median follow-up of 833 (interquartile range 415-1447) days, in-stent minimum lumen area (MLA) <4.5mm2 (HR 1.82, p<0.001), distal stent edge dissection >200mm (HR 2.03, p¼0.004), B18 JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, VOL. 70, NO. 18, SUPPL B, 2017