Winter growth is slow and is identified by closer spacing of the circuli. The number increases during slow winter growth and decreases. Growth during the summer is present as widely spaced circuli. a a A major pattern feature which determines annuli is the number of circuli per unit area. annular valves (Edwards Sapien Ultra) for small annuli (23 mm) Patient prothesis mis-match (PPM) remains a clinical dilemma in transcatheter aortic valve replacement (TAVR) and has been linked to higher rates of morbidity and mortality. A circular pattern of growth is laid down on the scale as the fish grows.
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